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We have recently noticed a lot of denials for 87150 when it is included in our pcr panels. We never had an issue before however; I know that Medicare has recently made some changes to how everything is billed.
This is how our panels are currently billed;
UTI Female - 87563, 87661, 87481, 87511, 87653, 87651, 87640, 87641, 87150 x12, 87500, 87801 x3, 87491 & 87591.
UTI Male - 87563, 87481, 87653, 87651, 87640, 87641, 87150 x12, 87500, 87801 x3, 87491 & 87591.
URI - 87637, 87541, 87581, 87651, 87486, 87640, 87641, 87150 x12, 87500, 87801 x 3
Up until recently, we have been getting payments in full for our panels. Now we are seeing denials for the 87150. My understanding is that Medicare will not allow 87150 & 87801 to be reported together anymore. We have also tried to update 87150 to 87798 and are still getting denials. Our medical records and results provide supporting documentation to prove the level of tests.
We did have someone mention to try billing 87798 with XU modifier individually for each organism tested. Any suggestions or insight will be greatly appreciated.
This is how our panels are currently billed;
UTI Female - 87563, 87661, 87481, 87511, 87653, 87651, 87640, 87641, 87150 x12, 87500, 87801 x3, 87491 & 87591.
UTI Male - 87563, 87481, 87653, 87651, 87640, 87641, 87150 x12, 87500, 87801 x3, 87491 & 87591.
URI - 87637, 87541, 87581, 87651, 87486, 87640, 87641, 87150 x12, 87500, 87801 x 3
Up until recently, we have been getting payments in full for our panels. Now we are seeing denials for the 87150. My understanding is that Medicare will not allow 87150 & 87801 to be reported together anymore. We have also tried to update 87150 to 87798 and are still getting denials. Our medical records and results provide supporting documentation to prove the level of tests.
We did have someone mention to try billing 87798 with XU modifier individually for each organism tested. Any suggestions or insight will be greatly appreciated.