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Old 05-14-2010, 06:24 AM
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neha.bhatnagar neha.bhatnagar is offline
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Question Medicare denied CPT 81000

Hi All,

Medicare has denied CPT 81000 stating "This provider was not certified/eligible to be paid for this procedure/service on this DOS."

DidDo we need to add any modifier to 81000?? E.g QW modifier

Please help..

Neha Bhatnagar CPC, CPC-H

"Believe you can and you're half way there."
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Old 09-03-2010, 02:16 PM
bill2doc bill2doc is offline
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I'm getting the same denial. I don't think QW will change anything as the 81000 is not clia waived. We have a type 4 certification and I can't seem to figure out why one dr in our office gets paid for this code and the other doesn't.... please let me know if you find out anything. Thanks
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Old 09-14-2010, 12:57 PM
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Stefanie Stefanie is offline
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Do your providers have PPMP certificates - Provider Performed Microscopy Procedures certificate? There are only a few tests that need this certificate to qualify, but 81000 is one of them.

Stefanie Cramer, CPC
Sr. Coding Specialist
Cape Fear Valley Health Systems
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