Medical necessity for 86580 ppd testing

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I have a physician in Missouri that is doing the initial exam and testing of patients entering a nursing facility. He is testing for TB w/ 86580 and using dx code of v74.1, which is being denied by Medicare. Medicare is stating that V74.1 is considered routine. All the information I have found is suggesting the use of V74.1. Can anyone help me find a code that supports medical necessity?
 

mdl1966

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V74.1 is correct, are you changing the POS to 99? I know that you use to have to make the place of service a 99 in order to get paid, no matter what the actual POS is. Not all insurance companies will pay for a PPD unless there has been confirmed exposure. I hope this helps.
 
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Has anyone noticed that as of November these have been getting denied by Medicare when they were previously getting paid? Has something changed? We've never used POS 99. Does modifier 33 work on these tests?
 
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