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Wiki 81382 and 81378

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flam2accent@yahoo.com

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I do code reviews for denied claims. Theses labs 81378 and 81382 are usually deny because of the billed units. This is for a cancer care center, I do not have much experience with oncology pathology coding. I am finding it difficult to validate if all the billed units were performed, I suspect they are and the MCR MUE only allows 6 of 81382, often times I get 15 or more. I do not know if the medical records reflect all the information or if the coders at the facility are getting the information from a different source. 81382 is especially a problem, this is performed and billed on REV code 815, Donor/Allogenic Stem ACQ or living donor/organ acquisition REV code 811. Question: Is each billed unit done per donor for a match? I am having a hard time validating these and how, when I see the HLA, DRB, DQB, DQA, etc, etc. Any help would be appreciated.
 
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