Wiki 88363 - We are billing the professional component

mmary1

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We are billing the professional component for an independent lab. We have been receiving rejections when coding 88363, a mixture of auth not obtained and some for medical necessity. Medicare seems to pay the 88363 if the POS is correct. However, the Blues and Aetna continue to deny. Anyone having this problem, too?? Thanks.

Aetna suggested using POS 81 and no 26 mod. We were not appending the 26 mod on the 88363. Has anyone had success using POS 81? Thanks.
 
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