Clia denial 1419

newfiegirl

Networker
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I am getting denials from a Medicare Advantage Plan stating CLIA Certification Level not met. I can not get clear information from carrier. Any suggestions/help would be appreciated. Thank you
 

thomas7331

True Blue
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If you go to the CLIA section of the CMS web site (link below) you should be able to find information that will answer most of your questions about this. On this web page, you'll see a link in the left-hand column for 'Categorization of Tests' and that will take you to a page that has documents listing all of the codes that have CLIA edits and the level of certification that is required in order to perform that procedure. Hope this will help you as a starting point for researching the denials.

https://www.cms.gov/Regulations-and-Guidance/Legislation/CLIA/index.html
 
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