Wiki Dx code med necessity

[suela923@aol.com]

I am receiving denials from one commercial carrier for a dx of
V72.84 and 622.12 for 84702. This is a pre op test for pregnancy before surgery. It seems logical to me so I am not sure why it denies for medical necessity. Any suggestions? Thanks, Sue

 

[dclark7]

Why are you doing a quantitative test (84702) instead of qualitative (84703)? All you really need is a yes or no if the pt is pregnant which the qualitative test will give you. That could be why it's denying for medical necessity