Medicare denial for Tuberculosis test

[StacyTerramiggi]

We are billing this out to Medicare as 99211 level one visit and attaching code V74.1 screening for pulmonary Tuberculosis and this is getting denied as a screening or routine exam. Does any one have any insite as how our office can possibly get this paid? Thank you!!

 

[philipwells]

From past experiences, Medicare doesn't accept any primary diagnosis when it's a v-code. Always considered routine. The only time they will typically pay for this is if it is their welcome to Medicare visit. TB tests will always be considered routine unless you have a medical diagnosis to support as primary.

 

[mitchellde]

Medicare does accept V codes as primary when it is the correct code. In this case TB screening is not coded with 99211. You use the code for TB screening, it is a lab code.

 

[StacyTerramiggi]

TB test

Medicare does accept V codes as primary when it is the correct code. In this case TB screening is not coded with 99211. You use the code for TB screening, it is a lab code.

Thank you for your reply and I should have put in my post we are billing it out with the lab code for the test itself, it is the reading of the test I am finding that they are not paying. As far as the lad code for the test with the V code I am still waiting for those yet to process

Thank you both so much!!

 

[debrakae]

Normally the reading of the test is included as part of the test.

 

[arrana]

We don't bill the reading, just the plant - for all payors.