{"id":20857,"date":"2019-03-26T09:00:16","date_gmt":"2019-03-26T13:00:16","guid":{"rendered":"http:\/\/www.carecloud.com\/continuum\/?p=20857"},"modified":"2025-10-23T12:41:26","modified_gmt":"2025-10-23T12:41:26","slug":"91-modifier","status":"publish","type":"post","link":"https:\/\/carecloud.com\/continuum\/91-modifier\/","title":{"rendered":"Procedure Coding: When to Use the 91 Modifier"},"content":{"rendered":"<h2><span style=\"font-weight: 400;\">Procedure Coding: When to Use the 91 Modifier<\/span><\/h2>\n<h3>This is part of the Modifier Series, the articles include:<\/h3>\n<ul>\n<li>Modifers<a href=\"https:\/\/www.carecloud.com\/continuum\/modifier-59-25-91-guide-coders\/\"> 59, 25, and 91<\/a><\/li>\n<li>Modifier <a href=\"https:\/\/www.carecloud.com\/continuum\/procedure-coding-when-to-use-the-59-modifier\/\">59<\/a><\/li>\n<li>Modifier <a href=\"https:\/\/www.carecloud.com\/continuum\/procedure-coding-25-modifier\/\">25<\/a><\/li>\n<li>Modifier <a href=\"https:\/\/www.carecloud.com\/continuum\/modifier-26\/\">26<\/a><\/li>\n<li>Modifier <a href=\"https:\/\/www.carecloud.com\/continuum\/procedure-coding-modifier-22\/\">22<\/a><\/li>\n<li>Modifier <a href=\"https:\/\/www.carecloud.com\/continuum\/modifier-51\/\">51<\/a><\/li>\n<li>Modifier <a href=\"https:\/\/www.carecloud.com\/continuum\/procedure-coding-modifier-53\/\">53<\/a><\/li>\n<li>Modifier <a href=\"https:\/\/www.carecloud.com\/continuum\/procedure-coding-58-modifier\/\">58<\/a><\/li>\n<li>Modifier <a href=\"https:\/\/www.carecloud.com\/continuum\/52-modifier\/\">52<\/a><\/li>\n<li>Modifier <a href=\"https:\/\/www.carecloud.com\/continuum\/79-modifier\/\">79<\/a><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">We all know how difficult it can be to get payers to reimburse appropriately when a claim is sent completely clean. But forget just one modifier and you can easily fall into a tedious cycle of denials, corrected claims and appeals &#8211; nobody\u2019s idea of a fun time. In order to prevent further frustration around getting your claims and providers paid, it\u2019s important to have accurate coding knowledge on your side. <\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">In discussing the 91 modifier, we\u2019ll clarify how it applies to repeated lab tests done on the same day for the same patient. Why does this matter? Specifically, because modifier 91 deals with showing that a repeated service was done with intent and should be a payable service.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Defining Modifier 91<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Modifier 91 is defined by CPT<\/span><span style=\"font-weight: 400;\">\u00ae as representative of<\/span> <i><span style=\"font-weight: 400;\">Repeat clinical diagnostic laboratory test, <\/span><\/i><span style=\"font-weight: 400;\">and<\/span> <span style=\"font-weight: 400;\">is used to indicate when subsequent lab tests are performed on the same patient, on the same day in order to obtain new test data over the course of treatment. You can probably understand why it\u2019s important to append appropriate modifiers when billing the same CPT two or even three times on the same day for the same patient. Imagine the claim from the payer\u2019s perspective, and it would appear to be duplication of services, earning these claims an immediate denial.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">The 91 modifier is most often confused with the 59 modifier, used for <\/span><i><span style=\"font-weight: 400;\">distinct procedural service, <\/span><\/i><span style=\"font-weight: 400;\">and this is understandable. However, it\u2019s important to note that while modifier 59 may make sense for many scenarios, modifier 91 allows billing to the highest specificity due to it being a modifier for lab tests only. Modifier 91 should be billed instead of 59 in most lab cases, so it\u2019s important to learn how to use it appropriately.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">To provide more insight into when you\u2019d need to apply the 91 modifier, and to underline the importance of its appropriate use, here are some clarifying examples of modifier 91 at work. <\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Clinical Scenarios<\/span><\/h2>\n<p><b>Modifier 91 Example 1<\/b><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">A patient is seen in the ER, where her physician orders a blood glucose meter lab test. Later during the same visit, the physician orders a second BGM lab test in order to identify separate accession and result numbers. Appropriate coding of this encounter would be: 82962; 82962-91.<\/span><\/p>\n<p><b>Modifier 91 Example 2<\/b><\/p>\n<p><span style=\"font-weight: 400;\">An elderly male patient with diabetic ketoacidosis had multiple blood tests performed to check his potassium levels following potassium replacement and low-dose insulin therapy. After the initial potassium results, three subsequent blood tests were ordered and performed on the same date to monitor his blood levels over the course of the potassium treatment. Coding for this scenario is:<\/span><\/p>\n<p><span style=\"font-weight: 400;\">84132 <\/span><i><span style=\"font-weight: 400;\">Potassium; serum, plasma or whole blood<\/span><\/i><\/p>\n<p><span style=\"font-weight: 400;\">84132-91; 84132-91; 84132-91<\/span><\/p>\n<h2><strong>When not to use Modifier 91<\/strong><\/h2>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">On a repeat lab test performed only to confirm initial results<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">When a lab test was repeated due to a problem with the specimen or equipment<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">When a series of lab tests would be better represented by another code; for example, glucose tolerance testing under code 82951 already includes 3 specimens under one code, so modifier 91 would not apply.<\/span><\/li>\n<\/ul>\n<h2><span style=\"font-weight: 400;\">Summary<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The 91 modifier may have its points of confusion, but a little clarification can go a long way. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">As the standard rule for billing modifiers regardless of their individual use, supporting documentation of the services performed should be maintained in the patient&#8217;s medical record. This documentation will need to do more than prove medical necessity. It also needs to substantiate that the repeat lab tests were performed separately and appropriately to rule out any questioning from the payer.<\/span><\/p>\n<p><strong>Sources:<\/strong><\/p>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li>\u00a0<a href=\"https:\/\/www.aapc.com\/blog\/42006-how-to-append-modifier-91-appropriately\/\" rel=\"nofollow\"><span style=\"font-weight: 400;\">https:\/\/www.aapc.com\/blog\/42006-how-to-append-modifier-91-appropriately\/<\/span><\/a><\/li>\n<li><a href=\"https:\/\/www.aapc.com\/blog\/28269-proper-use-of-modifier-91\/\" rel=\"nofollow\"><span style=\"font-weight: 400;\">https:\/\/www.aapc.com\/blog\/28269-proper-use-of-modifier-91\/<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Procedure Coding: When to Use the 91 Modifier This is part of the Modifier Series, the articles include: Modifers 59, 25, and 91 Modifier 59 Modifier 25 Modifier 26 Modifier 22 Modifier 51 Modifier 53 Modifier 58 Modifier 52 Modifier 79 We all know how difficult it can be to get payers to reimburse appropriately [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":43588,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[389],"tags":[],"class_list":["post-20857","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-resources"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - 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