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Modifier Question: Multiple 36415 on same DOS

Hattiesburg Posted Tue 07th of February, 2017 15:12:51 PM
What modifier do you bill when a patient has two 36415 charges on the same DOS? Example: Patient has an imaging study that requires a creatinine level. We charge for the creatinine and the 36415. The patient has a follow up office visit on the same date and more lab is ordered (and can't be added on to the previous draw due to specimen type). Do we use a modifier 91, 59, or 76/77 for the second medically necessary draw? Note: I know some carriers will only pay for one but some will pay for multiple. Please advise.
SuperCoder Answered Wed 08th of February, 2017 02:09:56 AM

The practitioner MUE value of CPT code 36415 is “4” units which means this code can be billed to a maximum of 4 units in a day. As your documentation states that 2 venipuncture was done to draw 2 blood samples on the same date of service. So, you can bill 2 units as 36415 x1 and 36415 with 76 modifier x1 on different claim lines.

Hope the provided information would be successful.

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