Wiki TB test denials

[hirakhee]

Hello! we are a specialist office, seeing denials for TB test CPT 86481 billed with ICD-10 Z11.1, we need to do the TB screening before prescribing certain medications. These denials are from UHC Medicare and Aetna so far. Has anyone encountered similar denials? If so, any thoughts/opinions on how to resolve this issue?

 

[lgardner]

I have found that many payers are wanting the reason for the TB test to be coded, too.

the options for the 'administrative exams' are:
Z02.0 - for admission to an educational institution
Z02.1 - for pre-employment
Z02.2 - for admission to a residential institution

I add the "admin" code following the Z11.1.

hope this helps.