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Wiki 91038 Esophageal function test

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Nancy Klein

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Saginaw, MI
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Hello,
We billed a Medicare Advantage carrier for an Esophageal Funtion Test 91038 with a diagnosis of 783.21 (loss of weight). The claim denied as a non-medically necessary diagnosis. The carrier states this is a CMS policy guideline; however, we were unable to locate any diagnosis restrictions. Does anyone know of any CMS policy for this procedure?
 
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