ShanHoff89
New
I work for an independent lab, was wondering if any other labs are having luck getting paid on appeal for G0481,G0482 and G0483 with Humana? Their drug testing policy states not covered but we have a high % of providers that order more than 7 drug classes.
If so, if you could share what you are requiring of your ordering provider?
Do you require your ordering provider to send in documentation if they are ordering confirmatory testing for more than 7 drug classes?
Currently, all we receive from our ordering is a paper form or online order with tests ordered, dx code and medical necessity statement but no documentation is required and when we appeal with that and report majority time it gets denied that documentation does not cover medical necessity. The medical necessity statement is usually "randomly test for prescription compliance"
Any feedback welcomed.
If so, if you could share what you are requiring of your ordering provider?
Do you require your ordering provider to send in documentation if they are ordering confirmatory testing for more than 7 drug classes?
Currently, all we receive from our ordering is a paper form or online order with tests ordered, dx code and medical necessity statement but no documentation is required and when we appeal with that and report majority time it gets denied that documentation does not cover medical necessity. The medical necessity statement is usually "randomly test for prescription compliance"
Any feedback welcomed.