Wiki 81002- Medicare Denial-Policy Location?

[Coder07]

We are getting denials for 81002 from Medicare when billed with an E/M and going thru the forums I see alot are having the same issues. Now for the life of me I cannot find anything that states it is exclusive to an E/M. I have searched in the NCCI edits and researched everywhere and anywhere where this topic was mentioned. It is really getting to me that I cannot find any official guideline.

If possible does anyone have a link to where this is stated or can someone guide me to the correct site.

I would appreaciate this so much! Thanks.

 

[Herbie Lorona]

I haven't had this problem. What is the denial codes you are getting for this?

 

[CPAGAN]

I am seeing the same issue and am stumped as well. The denial codes are 4, N657, MA15, and MA130. Can anyone help us?

Thanks,
Cindy

 

[chevygirl54]

81002

I am also getting the same denial

 

[Herbie Lorona]

Is this the only lab code you are having issues with? Are you billing a modifier on the lab code? Do you have your CLIA # on the claim?

 

[CPAGAN]

I think I see what is wrong in system. I can't see it in the system itself, but on the claim a QW modifier is being added when 81002 is exempt from this.

Thanks-Cindy

 

[Herbie Lorona]

!