Wiki 81002- Medicare Denial-Policy Location?

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Coder07

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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.:confused:

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.
 
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
 
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?
 
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
 
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