Results 1 to 2 of 2

pre op labs denied by Medicare

  1. #1
    Melbourne, Florida
    Default pre op labs denied by Medicare
    Medical Coding Books
    Medicare denied labs/ we billed for a pre op exam / medicare paid for the visit and xray but
    denied the ua + 36415 as as non covered /rtn exam included in payment

    would it make a difference if we put a modifier 59 on the ua
    modifiers 59 / 51 on the 36415?
    99214 v72.83, 715.15, v72.82, v72.63 .........................(paid)
    71020 v72.82 pre procedural repiratory exam ....(paid)
    81002 v72.63 (pre op labs) ................................... (denied)
    36415 v72.63 ( pre op labs)................................... (denied)
    I will look at the ncci edits..just wanted to throw this out there for any suggestions .. Thanks
    Denise Gilrane-Pillow, CPB

  2. Default
    You may need to add another dx in addition to v72.63. Our policy at the clinic I work for is.. for Medicare preop labs we bill the co-morbidity (if applicable), V72.63, and then the reason for surgery. For medicare preop ekgs we bill the co-morbidity (if applicable), v72.81, and then the reason for surgery.

Similar Threads

  1. Wiki Z00.00 denied for wellness labs
    By in forum ICD-10
    Replies: 3
    Last Post: 04-07-2017, 11:58 AM
  2. Pre-operative labs
    By JCampbell in forum Medicare Regulations
    Replies: 2
    Last Post: 05-05-2015, 01:44 PM
  3. Pre-Op PT/INR Denied
    By Jacoder in forum Billing/Reimbursement
    Replies: 7
    Last Post: 03-16-2012, 10:05 AM
  4. Pre-op Exam with EKGs and Labs
    By kcaskey03 in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 11-02-2011, 01:13 PM
  5. POS for pre-op labs
    By tomtom2 in forum Pathology & Clinical Laboratory
    Replies: 0
    Last Post: 09-27-2010, 12:01 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.