Wiki V76.51 for Noridian Medicare

[jbarkercpc]

Has anyone else been getting denials for V76.51 as routine not screening for cancer. Noridian Medicare is indicating this is routine. I explained it's used for screening for cancer of the colon, but they keep stating it's routine and patient is responsible. They are the only Medicare carrier, that I'm aware of, that does this. We do use the 33 modifier also.

Any help will be appreciated.

 

[syllingk]

your post is too vague. What is being denied and how was it billed. If it is an E/M. Noridian won't pay it.

 

[mitchellde]

What code are you using for the colonoscopy. Because the G code for screening colonoscopy would not have a 33 appended.