umcanes4
Guru
Good afternoon!!! I have been pulling my hair out for the past couple of days with these 2 codes. I have been helping our business office with some medical necessity edits they are getting for the 88342 and 84134.
I have read the LCDs over and over and it looks like a bunch of blah.
For the 88342, I notice they are doing this with our GI endo biopsies. Is it just the type of scenario where the service provided is outside the scope of the purpose of that procedure?
For the 84134, I see something on MedAssets that says something along the lines of payment for most lab tests will be package under the OPPS, therefore the lab tests listed below are packaged in this setting. Does that mean it is just not covered at all and payment for it is included in whatever else was drawn that day?
I feel stupid. This is my first time coming across issues like this. Thanks in advance for your help.
I have read the LCDs over and over and it looks like a bunch of blah.
For the 88342, I notice they are doing this with our GI endo biopsies. Is it just the type of scenario where the service provided is outside the scope of the purpose of that procedure?
For the 84134, I see something on MedAssets that says something along the lines of payment for most lab tests will be package under the OPPS, therefore the lab tests listed below are packaged in this setting. Does that mean it is just not covered at all and payment for it is included in whatever else was drawn that day?
I feel stupid. This is my first time coming across issues like this. Thanks in advance for your help.