Wiki Syphillis, Quan Analysis Coding

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We have not been successful in receiving reimbursement for this test, code 86593, with the following ICD-9 codes:

v01.6 Exposure to venereal diseases
v01.79 Exposure to HIV/other viral diseases/prophylaxis NOS
v75.9 Special screening for unspec infectious disease
042 HIV

The typical rejection code is CO45. Any suggestions?

Thanks,
Louise Cook
 
They won't pay for this if the patient has HIV? That is hard to imagine.

The only other that I can think of for a screening is V69.2 High-risk sexual behavior but if they aren't paying for the others I doubt this will fly either.

Sorry not more helpful,

Laura, CPC, CEMC
 
I would use code 097.1, which would justify performing a quantitative test. I would assume the patients who are having this test done already had a positive reaction w 86592 which is the qualitative exam. Seems like the V codes you have been using are not specific enough. A quantitative test is usually ordered after the qualitative test was positive.
 
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