Hi all,
I'm new to the forums and not a coder, but I am tasked with helping our patients resolve billing issues with our lab vendor (Quest).
A patient with Unicare is being denied coverage of three preventive lab screenings: HIV screen, HepB screen and HepC screen.
The patient's insurance lists all three of those screenings under their Preventive Care Schedule, but they insist that they will only cover the screenings with a medical diagnosis code (assuming that means a symptom based code).
They tell me they will not cover any of the screenings with the various Z-codes we have tried to use.
The patient is furious ($600) and I am at a loss -- am I missing something here?
Anyone have any experience with trying to bill for similar tests? I don't understand why they would require a diagnostic code for a test that is listed under their covered Preventive screenings.
Any thoughts or guidance is appreciated!
Cyndi
I'm new to the forums and not a coder, but I am tasked with helping our patients resolve billing issues with our lab vendor (Quest).
A patient with Unicare is being denied coverage of three preventive lab screenings: HIV screen, HepB screen and HepC screen.
The patient's insurance lists all three of those screenings under their Preventive Care Schedule, but they insist that they will only cover the screenings with a medical diagnosis code (assuming that means a symptom based code).
They tell me they will not cover any of the screenings with the various Z-codes we have tried to use.
The patient is furious ($600) and I am at a loss -- am I missing something here?
Anyone have any experience with trying to bill for similar tests? I don't understand why they would require a diagnostic code for a test that is listed under their covered Preventive screenings.
Any thoughts or guidance is appreciated!
Cyndi