Recently Medicare is denying my ua's (81002) stating reason 16 Claim/service lacks information or has submission/billing errors; and N575 Mismatch between the submitted ordering/referring provider name and the ordering/referring provider in our records. N264: Missing/incomplete/invalid ordering provider name. They are paying for the E/M service the same day and I'm using a 59 modifier showing that this was a separate lab procedure. Anyone know why this is happening? Just started this past few weeks.
-
If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
Wiki Medicare is Denying My Ua's (81002)
- Thread starter shirleyj1608@gmail.com
- Start date
please see this article. you need -25 on E/M
http://www.medicarepaymentandreimbursement.com/2016/08/cpt-codes-81001-81002-81003-and-81025.html . it also explains the N264 denial requirements
http://www.medicarepaymentandreimbursement.com/2016/08/cpt-codes-81001-81002-81003-and-81025.html . it also explains the N264 denial requirements
SharonCollachi
Guest
If there is no referring doctor other than your own doctor, put that info in box 17. A lab done in the office will deny without a referring/ordering doctor, which is what it sounds like they are telling you.