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Wiki Preventative Lab Codes

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kkdillon1204

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Recently, we have seen an increase in lab service claims denied as non preventative, even when using Z00.00. Anyone seen the same? Where can I get information on the changes? I checked CMS and found a list of non covered codes, including the Z codes. :mad:
 
Have you reviewed the PPACA policy for the payer? Some of them want the specific screening for codes, ex: for diabetes you can use Z00.00, z00.01 or Z13.1 but you also have to have a hypertension dx or CKD. Cholesterol if they won't take Z00.00 try Z13.220. This is from the United Healthcare policy. I know the Blues also have PPACA dx's they go by
 
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