Wiki swab included in e/m visit?

[jifnif]

when a dr does a rapid strep (87880) and then sends out a swab, isn't that swab included in the e/m visit?

 

[HBULLOCK]

Rapid strep

When you do a rapid strep during an office visit you bill for it(87880). If you then send it out for further culture (87077)you cannot charge for the culture since you did not perform in office. Hope this helps :d

 

[jifnif]

what if you do both due to a neg rapid and then swab to send out?

 

[HBULLOCK]

E/m w/rapid strep

We do both the rapid strep and culture if the rapid comes out neg so we bill for both. If you only do the rapid and send out for the culture you can only bill the rapid with the e/m. You could bill a handling charge 99000 for the send out but most insurances don't pay for that!:d

 

[jifnif]

when you say you do the culture for both, do you read the culture that normally gets sent out? sorry to ask so many questiosn, i normally don't do fam prac but one of our practices is looking for documented guidelines and i can't seem to find anything. i know that they do a rapid, and if it is neg they do a swab and send out for a culture. it is my understanding that you can only code the culture if you read it. True?

 

[HBULLOCK]

Strep

It's my understanding that you cannot bill for it unless the culture is processed and read in your office:d

 

[jifnif]

Thanks, that is what I wanted to clarify. Do you use a modifier if you do both? or a mod w/ the 99000?

 

[HBULLOCK]

E/m with strep

No we don't use a modifier as these are lab tests and not considered "procedures". :d

 

[jifnif]

Thanks, helen!