Wiki CLIA CERTIFICATE

[CODE.REBECCA.DEWICK]

I need HELP! i have medicare claims denying for cpt 87220- it states our clia # doesnt cover the test. our office verified through the dept of health and senior services that our # is correct and DOES cover cpt 87220. Medicare has the correct clia # but says not valid and wont budge. anyone else having this issue?

 

[trarut]

What type of certificate do you have? Look at the actual certificate (or a copy of it). Make sure it matches what DHSS told you. Medicare rules all in terms of which codes are billable under the specific certificates so I'm not surprised they aren't budging.

Also, just to make sure - is 87220 the correct code or did you mean 82270?

 

[kseebeck]

I believe you need to have a subspecialty of Mycology and/or Parasitology to bill 87220. I would check to see if that is the issue.

 

[cfordCPC]

I believe Q0112 is what you would bill to Medicare for KOH test.