Wiki Screening w/biopsy without findings

[erin.stevenson@att.net]

Getting a Medicare denial for screening colonoscopy. Dr. took biopsy but nothing was found. Coded;
Z12.11 45380-PT
Medicare denying b/c Z12.11 is not covered on LCD and no second diagnosis(nothing found). What should I do to get his paid??

 

[mconner001]

Why was a biopsy taken? Code that. Routine biopsies on a screening colonoscopy wouldn't be considered medically necessary.