Wiki Respiratory Viral Panel billing

[DEBRAV]

Good Moring-
Does anyone have any knowledge on how to bill COVID, FLU A and B, and RSV. We are getting denials stating use a more appropriate code(instead of all 3 dodes) so we tried 87637, We are verifying that the diagnosis used us on CMS LCD listing, however some of the Louisiana Medicaid plans are still denying due to the diagnosis. We have sent reconsiderations and that too is denied for diagnosis. I was told to follow CMS guidelines , but we are. Can anyone help??

 

[brucep]

87637 looks to be the correct code for the test. Medicare-acceptable diagnoses for 87637 are listed in LCD A58741. Assuming you are billing in an outpatient facility, one or more of these diagnosis codes should prove medical necessity.

diagnosis codes, diagnosis coding