Question:
What must documentation show if appending a modifier to bill multiple CPT® codes that represent analysis performed on a single specimen?
Answer:
Included in this NCCI update is guidance regarding separate billing of full gene sequence analysis and duplication/deletion analysis, stating that in general the two procedures would not be separately billed. If appending a modifier to bill multiple CPT codes that represent analysis performed on a single specimen, documentation in the medical record should clearly show physician determination of genetic analysis to be performed, the sequence in which testing was performed, a medical indication that links the multiple CPT codes to test results, and the diagnosis code that represents medical problems being managed by the ordering provider.
This question was answered in our Coding Essentials for Laboratories. For more hot topics relating to laboratory services, please visit our store or call us at 1.800.252.1578, ext. 2.
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