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Coding for home health services, rapid flu test


Understand appropriate coding for when a doctor certifies patient care plans while the patient is in home health care facilities. Also, how to code for a rapid flu test.

Q: What code do we use when the doctor certifies patient care plans while patients are in home health facilities?

Note: These codes are to be billed in monthly time increments. All services provided by a physician for a patient's care during a calendar month should be billed based on the total time spent, 15 to 29 minutes or 30 minutes or more.


Q: We have received differing advice as to how to bill the rapid flu test (87804). Should we bill this code as one unit or two?

A: If your office performs one test, using one sample and one device, to yield one analysis identifying a non-specific flu virus (neither A nor B), Type A flu virus only, or Type B flu virus only, then code using 87804 with one unit. Note: If two tests are run sequentially (one for Type A and the other for Type B), then two units should be reported.

If your office performs one test, using one sample and one device, to yield two separate, distinct results or analyses (including two results in a single analytical chamber) identifying Type A flu virus and Type B flu virus (positive or negative results for both), then code using 87804 with two units or append the 59 modifier to the second line item, as follows:

87804 –QW
87804 –QW, –59

Whether you bill with two units or the 59 modifier will depend on the payer.

The author is a compliance manager for Baptist Medical Associates in Louisville, Kentucky. Do you have a primary care-related coding question you would like to have our experts answer in this column? Send it to medec@advanstar.com

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