Certain Laboratory Codes Now Split-Billable

Effective retroactively for dates of service on or after February 1, 2010, the following laboratory CPT-4 codes are now split-billable and must be billed with the appropriate modifier 26, 99, TC or ZS. CPT-4 Code Description

• 80047 – 80076 Organ or Disease-Oriented Panels
• 80100 – 80103 Drug Testing
• 80150 – 80299 Therapeutic Drug Assays
• 80400 – 80440 Evocative/Suppression Testing
• 81000 – 81099 Urinalysis
• 82000 – 83018 Chemistry
• 83021 – 83909 Chemistry
• 83913 – 84163 Chemistry
• 84202 – 84999 Chemistry
• 85002 – 85055 Hematology and Coagulation
• 85130 – 85385 Hematology and Coagulation
• 85397 – 85557 Hematology and Coagulation
• 85597 – 85999 Hematology and Coagulation
• 86000 – 86063 Immunology
• 86140 – 86243 Immunology
• 86277 – 86318 Immunology
• 86329 – 86332 Immunology
• 86336 – 86480 Immunology
• 86590 – 86849 Immunology
• 87001 – 87158 Microbiology
• 87166 – 87206 Microbiology
• 87209 – 87999 Microbiology

The exceptions to this policy is that the following procedure codes remain non split-billable and may not be billed with modifiers 26, 99, TC, or ZS: 81007, 81025, 81050, 82044, 82962, 83013, 83014, 83876, 83912, 83951, 85060, 85097, 85397, 86077 – 86079, 86930 – 86932, 87905, 88141, 88184, 88185, 88187 – 88189, 88291, 88321, 88400, 88720, 88740, 88741 and 89055 An Erroneous Payment Correction (EPC) retroactive to February 1, 2010, will be performed for the providers who were denied payment.