When is modifier 91 applicable for testing?
Modifier 91 is applicable for the repeat of the same test on the same day when performed on a subsequently collected specimen. This modifier is used frequently for billing of repeat chemistry or hematology procedures. However, due to the limitation for use for testing on subsequently collected specimens, this modifier is not typically utilized for billing of histology procedures. Again, it is necessary to first validate the MUE limit for the CPT codes in histology to determine if quantity billing on a single line of the claim is appropriate.
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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