Wiki Obtaining additional ICD-10 codes after denial

[jmcfadden5]

Is it appropriate to reach out to an office/physician to ask for additional diagnosis codes if a patient states her lab test should have been covered, but she was told by her insurance that it was not for that diagnosis code? In this example, a pap smear was done because of her history of ASCUS, and Z87.42 was supplied. The test was normal this time.

Is querying for additional codes to get a test covered appropriate or inappropriate?

 

[sls314]

Is it appropriate to reach out to an office/physician to ask for additional diagnosis codes if a patient states her lab test should have been covered, but she was told by her insurance that it was not for that diagnosis code? In this example, a pap smear was done because of her history of ASCUS, and Z87.42 was supplied. The test was normal this time.

Is querying for additional codes to get a test covered appropriate or inappropriate?

Was the pap actually not covered? If so, what was the denial reason? Or was it just not processed as a screening, which left a balance to the patient?