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Correctly Code Rapid Flu Tests

When it comes to lab tests, one common area of missed revenue occurs with Rapid Flu tests. Doctors can purchase test kits for the Rapid Flu Test (87804) which tests for both A & B strains. Swabs are taken from the patient’s respiratory tract and the claim is coded based on the test results. If positive for 1 strain, bill 87804 once. If positive for both strains, bill 87804 on two separate line items with a modifier 59 on the second procedure line:

  • Line 1 87804
  • Line 2 87804-59

Medicare and most major payers reimburse for Rapid Flu Test, as long as you have a current CLIA license on file with the insurance company and Medicare.