We are having problems getting paid by Medicare for a TB skin test, which is required prior to starting Remicade treatment. Medicare is denying 86580, stating it is preventive. Is there a diagnosis code or a modifier we should be using, other than V74.1? Is there a HCPCS code to be used when the test is mandatory before starting treatment? We hesitate to bill the patient until we know for sure we have done everything to get it paid. I would appreciate any help you could give.