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Wiki 81002- Medicare Denial-Policy Location?

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Coder07

Networker
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Milwaukee, WI
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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.
 
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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