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HUMANA DENYING 87811QW AND 87804 59,QW

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LYNNRAFFERTY

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9
Location
Slocomb, AL
Our clinic routinely bills for covid and flu testing with no issues, but Human has started denying 87811QW and 87804 59,QW stating "Missing/incomplete/invalid HCPCS." Humana DOES pay for 87804QW, which is the part A flu test code, but is not paying for 87804 59,QW, which is the part B flu test. Medicare continues to pay for all these codes as well as all commercial insurances. Both are being submitted with qualifying DX codes. Can anyone provide guidance on this to me?
 
LYNNRAFFERTY said:
Our clinic routinely bills for covid and flu testing with no issues, but Human has started denying 87811QW and 87804 59,QW stating "Missing/incomplete/invalid HCPCS." Humana DOES pay for 87804QW, which is the part A flu test code, but is not paying for 87804 59,QW, which is the part B flu test. Medicare continues to pay for all these codes as well as all commercial insurances. Both are being submitted with qualifying DX codes. Can anyone provide guidance on this to me?
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Just started having the same exact denials. From all the guidance I have this is coded correctly. CMS Articles: A58817 & A54769, also according to Humana Claims Payment Policy Subject: Laboratory – Diagnostic Testing for Influenza Policy number: LAB2023031
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