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Last Modified: 5/18/2022 Location: FL, PR, USVI Business: Part B

Duplicate editing for COVID-19 laboratory services

Generally, duplicate editing prevents allowing payment on claims lines that contain the same procedure code as previously paid lines. First Coast understands that if initial testing is negative but the suspicion for COVID-19 remains and determining the presence of infection is important for management or infection control, repeating the test should be allowed.
First Coast has duplicate editing in the Part B claims processing system (Multi-Carrier System [MCS]) for the COVID-19 laboratory codes U0001, U0002, U0003, U0004, and 87635. The system editing will allow payment for repeated tests on the same date of service. The claim lines for the repeated laboratory service should be billed with the applicable modifier, 59 or 91.
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.