Wiki Medicare billing-9944x with Z11.59 covid screen code

[SienTC1720]

We have billed this with the -CS modifier and are getting the denial:
ROUTINE EXAM OR SCREENING PROCEDURE PART OF A ROUTINE EXAM.
I see in a medicare COVID FAQ that this seems to be how it should be billed.
Any one else had this issue and/or know how to fix it?

 

[thomas7331]

We have billed this with the -CS modifier and are getting the denial:
ROUTINE EXAM OR SCREENING PROCEDURE PART OF A ROUTINE EXAM.
I see in a medicare COVID FAQ that this seems to be how it should be billed.
Any one else had this issue and/or know how to fix it?

I responded to your question on a previous thread, which I'll post again here:

The AHA issued guidance in July that screening codes are not appropriate during a pandemic and that testing of asymptomatic patients for COVID-19 should be coded with Z20.828 instead.

Medicare only covers limited preventive and screening services as specified in the law and screening for viral diseases is not one of them, so that it most likely the reason if you are seeing denials.

I'd just add here too that a telehealth visit is not a screening but an evaluation and management service, so that diagnosis is likely not appropriate for this code in any case, in my opinion.