Medicare and MA plans denying 80307

sammartin92472

Networker
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26
Location
Spartanburg, SC
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Our office performes presumptive drug testing on our pain management patients in our in house lab, we send out for definitive results. This year we are now filing 80307 for these presumptive drug screens. I've gotten a good many denials from Medicare and Medicare Advantage plans with the reason "This service is not covered by Medicare". Is anyone else having issues getting Medicare to pay and do you know the reason? Is there some kind of modifier we should be putting on these? I don't think we did with the G code we used prior to 2017. Help!!
 

Pbhatt1

Networker
Messages
46
Location
Riverview, FL
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G code

Medicare pays for G0479 per 2016 CMS guidelines. But, in 2017 they use same codes 80305 80306 80307 and no modifier needed to override the bundling. Unit one per billing.
 
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