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Ask a Rev Cycle Expert: Repeat Troponin Reporting?

Question:

We sometimes have a lab test that we repeat multiple times on the same date of service. For example, troponins are usually repeated several hours apart. For Current Procedural Terminology (CPT®) code 84484, what is the best modifier to use?

Answer:

For the subsequent test, report modifier 91 Repeat Clinical Diagnostic Laboratory Test with CPT® code 84484 Troponin, quantitative. Modifier 91 is used to indicate the test is being repeated. Modifiers 59 Distinct Procedural Service or X[E,S,P,U] would be used to bypass a National Correct Coding Initiative (NCCI) edit.

It should be noted that guidance is different when a laboratory panel is provided and then a component of the panel is repeated. Guidance indicates that either modifier 59 or 91 may be used. For example, if a comprehensive metabolic panel (CPT® 80053) is reported, and then a glucose test (CPT® 82947) is repeated, then either modifier would work.

Of note, the repeat testing may not be separately reportable if it is done to confirm the initial results or for instances where there may have been issues with the specimen or equipment.

Disclaimer: This information was current at the time of its publishing and is designed to provide accurate information in regard to the subject matter covered. Vitalware does not accept any responsibility or liability with regard to any errors, omissions, misuses, or misinterpretation by the reader. It is not intended to take the place of either the written policies or regulations. We encourage you to review the specific regulations and other interpretive materials as necessary. All CPT® codes are trademarked by the American Medical Association (AMA) and all revenue codes are copyrighted by the American Hospital Association (AHA).