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Wiki 85018 and 83655 medical necessity

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lmbennett

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Hey Yall! I am receiving denials more frequently for Pediatric patients for Hemoglobin and Lead level testing. I have been using DX z13.88 and z13.0 that I saw in the American Pediatric coding guide 2020. Has anyone seen these denials, and do you have any feedback on what diagnosis I need to apply?
Thank you!
 
I bill pediatric claims. CPT code 85018 is the right code for office Hemoglobin procedure during an office visit. the question is are those procedures performed as a part of preventative care of sick visit? Different insurance has different benefit limited for this procedure. My suggestion is go back to review individual insurance contract
 
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