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UCR 195: FAQs - 99459 who's not paying; MUEs for J codes; PCR billing for a rectal swab?

May 17, 2024

Mark, Ray, and Scott discuss FAQs that came into the PRS Network Community.

  1. Are there payers not paying for 99459?
  2. Hello, the max units for J2704 is 80.  I have searched and searched and can't figure out how to bill additional units if more than 80 units is administered.  I have tried modifier 59 and my claim was still denied. Any help would be greatly appreciated.
  3. Can we bill 13 units for 87798 for UTI PCR and Rectal swab PCR?
    Would charging 87801 be better for rectal swab PCR? VS 87798



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