Laboratory Question for the Week of May 15, 2017

Laboratory Compliance Question of the Week

Question:

Can modifier 33 be used for laboratory claims?

Answer:

Modifier 33 communicates to a payer that the service or test being billed is preventive under pertinent laws and indicates that patient cost-sharing is not applicable. Documents issued by the Centers for Medicare & Medicaid Services (CMS) do not reference this modifier as applicable for laboratory testing billed to the Medicare program, so, for now, limit its use to the specific instruction of the commercial and private payers.

 

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.