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Last Modified: 12/1/2020 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 Service Options, Inc. (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.
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