Author Topic: Rapid Flu Test  (Read 3954 times)

rkillian

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Rapid Flu Test
« on: March 26, 2009, 01:13:15 PM »
What is the correct cpt code for billing a rapid flu test in the office?

Michele

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Re: Rapid Flu Test
« Reply #1 on: March 26, 2009, 06:26:02 PM »
If you are billing for the procedure in which you take a respiratory sample (e.g., throat or nasal swab, nasal aspirate or sputum) and do the rapid test, you should submit 87804, "Infectious agent antigen detection by immunoassay with direct optical observation; Influenza."  However, if you are using some other source (e.g., culture material) or technique, which would not generally be considered a "rapid" flu test, you should submit a different code, such as 87400, "Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple step method; Influenza, A or B, each.

Michele
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redeyecherry

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Re: Rapid Flu Test
« Reply #2 on: January 19, 2010, 03:44:29 PM »
I have been billing the Rapid flu test with 87804 modifier 59 and 87804 modifier QW, i used URI as diagnosis code but i am not getting paid.
Any suggestions?

Michele

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Re: Rapid Flu Test
« Reply #3 on: January 19, 2010, 08:00:28 PM »
What is the denial reason?
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redeyecherry

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Re: Rapid Flu Test
« Reply #4 on: January 20, 2010, 09:58:31 AM »
"The Providerwas not certified/eiligible to be paid for this procedure/service on this date of service"

PMRNC

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Re: Rapid Flu Test
« Reply #5 on: January 20, 2010, 10:22:03 AM »
That's not a denial based on WHAT you billed but rather the eligibility of the provider.
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Michele

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Re: Rapid Flu Test
« Reply #6 on: January 20, 2010, 08:29:41 PM »
It sounds to me like the provider doesn't have their CLIA waiver on file with Medicare.

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redeyecherry

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Re: Rapid Flu Test
« Reply #7 on: January 22, 2010, 03:49:05 PM »
OK thanks :D
i just appealed it with copy of the CLIA certificate - hoping it will finally go through now.
thanks a bunch for all the answers

Michele

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Re: Rapid Flu Test
« Reply #8 on: January 25, 2010, 07:29:09 AM »
I'm afraid that won't be enough.  I think they will require that you complete a CMS application with the CLIA waiver info on it.  There is a place in the CMS form to indicate if a provider has a CLIA number.

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redeyecherry

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Re: Rapid Flu Test
« Reply #9 on: January 25, 2010, 11:09:30 AM »
ah ok, well we do have the CLIA number in every claim when we send it and it is only medicare that wont pay so i hoped that will help.
Off to calling medicare then

thanks again