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Wiki Medicare and cardionets/93228/93229

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mcgraws

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Our office cannot seem to get 93228 or 93229 paid via Medicare. Medicare keeps telling us that it is an unproven code and not medically necessary. Can someone assist me in this matter or give me some tips!

Thanks and frustrated!:confused:

Tonya CPC
 
National Government Services (J13) has an LCD for these codes (L26415). I'm not sure what area you're in or who your MAC is, but you should check with them for an LCD. NGS covers these codes, but there are only 30 dx codes that support medical necessity. Check for an LCD then make sure that your dx codes are covered. If not you should be obtaining ABNs prior to doing these tests.
 
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