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Billing Dept

Nina Posted Thu 17th of March, 2016 17:27:39 PM

How many units ahould be billed for SIBO test interpretation, CPT 91065 with 26 mod.
Its 10 specimen test, do we bill for 10 units or 1?

Thank you

SuperCoder Answered Fri 18th of March, 2016 05:43:30 AM

We will bill only one unit of CPT 91065-26, as the test is performed only for SIBO.

Nina Posted Fri 18th of March, 2016 11:47:50 AM

We were told by equipment company that specific modifier should be attached to CPT 91065 to identify fructose, lactulose or lactose test. Is it correct?

SuperCoder Answered Mon 21st of March, 2016 05:55:19 AM

I have checked for the allowed modifier codes with 91065, so if the service is a distinct service from the one which is performed earlier than modifier 59 or XE, XP, XU, and XS can be used along with 91065. You can also confirm with your payer for any payer specific modifier to differentiate between services performed for fructose, lactulose or Lactose.

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