Billing a Column Two NCCI code for denial and w/o

We have a new Director of PFS that is implementing a billing SOP that I question. Billing for both 80306 and 80307 (drugs of abuse) generates a PTP edit stating that the two codes may not be submitted for the same date of service and a modifier will not be allowed. She is stating that we override the edit and bill without a modifier to get a denial that we then write off as noncovered. I am thinking that the part of the edit stating may not be submitted means that you should not even submit that code on the claim because you've been informed that it is not allowed. If that is the case, could we build a zero charge for the column two to capture utilization? Thanks for any guidelines that you follow for this scenario. If you'd like to call vs reply via discussion, please contact me at 802.888.8383.


  • We remove the charge from the claim and bill it out. We treat the removed charge as a non-covered adjustment. I agree with you about not putting it on there. To me, it just raises flags as to why you are trying to put something on there that should not be. As well as you run the risk of the whole claim denying because of this one line item.

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