Principal or Primary Diagnosis for Chemotherapy Administration
According to the ICD Manual guidelines, encounter for antineoplastic chemotherapy (ICD-10 code Z51.11) or encounter for antineoplastic immunotherapy (ICD-10 code Z51.12) must be the principal or primary diagnosis, followed by the diagnosis of the current acute disease or injury for chemotherapy administration (96401-96450, 96542-96549).
Procedures that are Bilateral in Nature (Bilateral Indicator 2)
These procedures do not have a unilateral counterpart, and the payment is based on the procedure being performed bilaterally. When these procedures are billed with a single anatomic modifier (LT or RT), then modifier 52 (Reduced) service should be appended.
Modifier -91 Repeat Clinical Diagnostic Laboratory Test
The billing of modifier -91 is used to report the same lab test when performed on the same patient on the same day and to obtain subsequent test results.
When reporting lab procedures, modifier 59 is used when the same lab procedure is done, but different specimens are obtained, or the cultures are obtained from different sites.
Example: Influenza A and influenza B are 2 separate strains, and you should bill 87804 for the first strain and 87804 with modifier -59 for the additional strain.