Modifier 92 | Alternative Laboratory Platform Testing Explained

Modifier 92 describes alternative laboratory platform testing. In this article, we will explain modifier 92, its appropriate usage, documentation requirements, billing procedures, common mistakes, related modifiers, and additional tips for medical coders.

1. What is Modifier 92?

Modifier 92 is a modifier used to indicate the use of an alternative laboratory platform test. This test is performed using a kit or transportable instrument that consists of a single-use, disposable analytical chamber.

Modifier 92 does not require a dedicated, permanent space to perform. Instead, a provider may hand-carry the test or transport it to a different location for testing.

2. When to use Modifier 92?

Modifier 92 is used when an alternative laboratory platform test is performed. This test is typically used when a traditional laboratory test is not feasible or practical. For example, when a patient is in a remote location or a rapid test result is needed.

3. Description

The official description of Modifier 92 is “Alternative laboratory platform testing”.

4. Examples

Examples of procedures that require Modifier 92 include an antibody HIV 1 test, a rapid strep test, and a rapid flu test.

5. Documentation

When using Modifier 92, it is important to document the use of the alternative laboratory platform test in the patient’s medical record. The documentation should include the reason for using the test, the type of test performed, and the results of the test.

6. Billing

To bill for Modifier 92, the CPT code for the laboratory test should be reported with Modifier 92 appended. Modifier 92 may affect the reimbursement rate for the test, so it is essential to check with the payer for specific billing guidelines.

7. Common mistakes

One common mistake that medical coders make when using Modifier 92 is failing to document the use of the alternative laboratory platform test in the patient’s medical record.

Another mistake is using Modifier 92 when it is inappropriate, such as when a traditional laboratory test is available. To avoid these mistakes, it is important to clearly understand the appropriate usage of Modifier 92 and document its use accurately.

8. Other modifiers related to Modifier 92

Other modifiers related to Modifier 92 include Modifier 91, which is used to indicate repeat clinical diagnostic laboratory test, and Modifier 90, which is used to indicate reference (outside) laboratory.