Wiki 83036

[newfiegirl]

We continue to get denials from Medicare for this code stating not medically necessary both on in-house and at the lab. We have used the R73 codes and have not been paid by Medicare. Is anyone being paid for these services and, if so, what if any of the R73 codes are being covered? thanks for any input.

 

[erjones147]

I have never gotten A1c's paid for any of the R73 codes. Also, I have gotten CO 50 denials for doing them too close together. What's your denial code?

 

[boomba003]

Frequently the problem is either frequency of service or using a non-covered diagnosis. Down load Medicare's NCD for Labs. It will give you the covered Dxs. At the end of the list, it will give you Indications and Limitations. Below is the link.


https://www.cms.gov/Medicare/Coverage/CoverageGenInfo/LabNCDsICD10.html

 

[newfiegirl]

Thanks for the information. I am receiving the same CO50 reason not medically necessary. I have made our providers aware and will use the appropriate dx codes.