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Wiki Florida Medicare 00811/00813

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ambaker

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Girard, IL
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I work for an anesthesia group. I have a question on billing for screening colonoscopy turned diagnostic. We bill Cpt 00811-PT, dual we bill 00813 (no PT). My question is the DX order. We used to get paid using the Z12.11 as the principal DX and the diagnostic DX in a secondary field. Now they are denying as PR49. Surgeons office informed us that we need to bill the Diagnostic DX as principal code and the Z12.11 in a secondary field. Anyone else have information on this? This is for Florida Medicare. I am unable to find any revision information. Thank you in advance.
 
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