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    Wiki How to bill PPD test to Medicare?

    I'm getting denials from Medicare for PPD test CPT 86580 with ICD10 Z11.1. The denial is PR49: This is a non-covered service because it is a routine/preventive exam or a diagnostic/screening procedure done in conjunction with a routine/preventive exam. Also, Medicare is denying the reading with...
  2. M

    Wiki Global period for PPD skin test?

    Is there a global period for the PPD skin test? The provider is wanting to bill for this encounter but I'm not sure if it should be included in the original service or not. The patient was given a PPD skin test 24 hours ago. She states she developed a large reddened area at the site and came in...
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    Wiki Coding for MD and APRN PPD placement and read

    My primary care office does not have RNs or LPNs so PPD visits are most often done by our mid-level providers, and occasionally our doctors. We have gone back and forth for years on the best coding practices for PPD placements and reads. Also, most of the time the placement is done in the...
  4. J

    FQHC Billing Lab Services to Medicare Advantage plans

    Hi, I work for an FQHC in Hawaii and we are having issues with billing PPD tests and other lab services to Medicare Advantage plans like UHC, WellCare, etc. Is there anyone else billing/coding for FQHCs who can share how they are billing labs to Medicare plans? According to the Medicare FQHC...
  5. J

    Nurse Visits 99211 Help

    Hi all, I've been hired as a coder after the clinic I work at updated to a new EMR system, and I've come across issues with coding for nurse visits. We've established that when patients come in for injections/vaccinations, we code for the injections/vaccinations and the correct admin codes...
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    UHC Medicare Solutions denying PPD

    We are currently having an issue with UHC Medicare Solutions denying our claims for 86580 (PPD) with diagnosis code Z11.1. They are not dropping it to patient responsibility. They are telling us we must write it off. In conversations with them, they are saying we must get an ABN signed so...
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    Can someone let me know if a LPN can plant the PPD for a patient? I know a RN can but not sure of the LPN. Also, the company I work for is now accepting CIGNA health plans and want to pilot PPD since its a required test needed for employees. Can a patient just get a PPD without an OV? Thank you!