This was discussed during the Sept. 2014 Q&A Webinar by Alicia Scott, CPC, CPC-I.
The proper modifier depends on the circumstances of the testing and whether it is a Medicare patient.
When the physician’s office performs this test in-house, modifier -92 (Alternative laboratory platform testing) may be applicable. HCPCS modifier -QW (Clinical Laboratory Improvement Act waived test) may also apply.
When the physician’s office employs an outside laboratory to perform the tests, report modifier -90 (Reference [outside] laboratory).
If this is not the first time the tests are being performed and reported for a particular patient, append modifier -91 (Repeat clinical diagnostic laboratory test).
When these tests are provided as part of a general colorectal cancer screening (in conjunction with codes G0104, G0105, G0106, G0120, G0121, or G0122), the payer may request that you report modifier -51 (Multiple procedures) or modifier -59 (Distinct procedural service).
Thanks for the question, Eileen!
