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Wiki Medical Necessity Question

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Afternoon to all, I am new to the coding world and I'm currently coding for and Urgent Care with multiple facilities and Providers. Having an issue with one wanting to use Otalgia (ear pain) as medical necessity for 87880 Strep test. All my research and guidelines including the ones from the Medical Director state is tied to pain in throat or fever. Any and all help would be greatly appreciated. The other coder here is also an apprentice. Thanks in advance, Debby
 
Medical Necessity

Hi I am a graduate from medical coding and billing in 2015 and just this week and took my CBC exam! I understand your frustration with medical necessity if you are getting denied on a claim make sure that there is the proper documentation besides a signed ABN, something stating that the patient agreed to make the payment and understood the guidelines such as notes from the Physician to help stabilize the need for medical necessity. Also remember depending on the state they may only except Medicare.
Good luck
 
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