Wiki 84702

DIRM123

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Hi, has any one been experiencing denials for 84702 for a coding issue? BCBS Highmark is denying all 84702 saying invalid dx code, I'm either coding it positive Z32.01 or Negative Z32.02 based on the lab result we have our own lab so its same day results. Any help would be appreciated!
 
Hi, has any one been experiencing denials for 84702 for a coding issue? BCBS Highmark is denying all 84702 saying invalid dx code, I'm either coding it positive Z32.01 or Negative Z32.02 based on the lab result we have our own lab so its same day results. Any help would be appreciated!
So I am assuming they don't like this Dx because of the CPT code you are using. Human Chorionic Gonadotropin (hCG) (quantitative) is useful for monitoring and diagnosis of germ cell neoplasms of the ovary, testis, mediastinum, retroperitoneum, and central nervous system. In addition, hCG is useful for monitoring pregnant patients with vaginal bleeding, hypertension and/or suspected fetal loss. This test is not normally done as a pregnancy test (qualitative which is CPT code 84703). So I suspect they are rejecting the Dx because the test code you are using must be accompanied by a problem diagnosis for which you are testing. If this is being done to simple confirm pregnancy, I would be asking for 84703 to be performed instead.
 
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