Laboratory Split-Bill Modifier Updates

Effective for dates of service on or after February 1, 2010, the laboratory procedure codes listed below will no longer be split-billable using modifiers 26, TC and ZS. These modifiers will be end-dated effective January 31, 2010, for all laboratory procedure codes that have been defined as non-split-billable.

CPT-4 Codes:

80047 – 80076, 80100 – 80103, 80150 – 80299, 80400 – 80440, 80500 – 80502, 81000 – 81099, 82000 – 83018, 83021 – 83909, 83913 – 84163, 84202 – 84999, 85002 – 85055, 85130 – 85385, 85397 – 85557, 85597 – 85999, 86000 – 86063, 86140 – 86243, 86277 – 86318, 86329 – 86332, 86336 – 86480, 86485 – 86580, 86590 – 86849, 87001 – 87158, 87166 – 87206, 87209 – 87999

Providers are reminded that codes that are not split-billable may not be billed with modifier 26, TC or ZS, or the claim will deny.

Source: December 2009 • Bulletin 426