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Wiki CO-170 (Medicare denials)

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kaldridge

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Anyone else having issues with claims denying with CO-170? We have several NPPs that have always ordered labs and mammograms and are now having their claims (randomly) deny with CO-170 and I can't find anything anywhere stating they aren't able to order these tests. We have called (numerous times) and of course they don't seem to really know what is going on either-they even told us at one point it was a system error and they were working on getting it fixed. So frustrating. Thanks, Kimberly
 
What services exactly are you billing that is being denied? CO-170 is usually a denial due to a procedure being outside of the provider's scope of practice - it doesn't have anything to do with who orders a test - it's who performs it.
 
It is for labs, cultures and mammograms.

And this is exactly what the girl at Medicare told us-it was an error in their system; it was looking at it as though the provider performed the service rather than just ordering it.
 
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