Wiki 80074 and 87522

[victorias1014]

Is it correct that when either of these tests are done, that you bill 3 times?

 

[boomba003]

MUE for both codes are 1. They can only be billed once on a DOS.

80074 is a panel and is subject to National Coverage Determinations (NCD) with Medicare. Once a hepatitis diagnosis is established, only individual tests can be ordered.

87522 is covered by Medicare with no NCD. Medically Unlikely Edit (MUE) of 1 it is unlikely to be paid for more than 1 but may be appealed.

wklyn@roadrunner.com