# Medicaid Reimbursement 96160 and 96161



## tracyread (Jul 25, 2017)

We are getting denials form our Oregon Medicaid when billing 96160 and 96161 with dx Z13.89 and Z13.9 in conjunction with an office visit and the 25 modifier.  Anyone else out there seeing this denial and if so have you found a fix?


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## hsher9179 (Sep 11, 2017)

We are seeing the same denials from Medicaid for 96160. We are encouraged to perform this screening service and the guidelines I have found on it indicate there is no ICD10 code that supports it except the Z13.9 and Z13.89 which they do not like used as principal diagnosis codes. They are denying our entire claim rather than paying the office visit and denying the screening charge. 
I have reached out to Medicaid and have been told to try to find a more specific dx code if I can, but there is no other way to code these when they are being done at every visit, regardless of the presenting problem, which usually has nothing to do with the screening itself.
If anyone comes up with a solution I would be happy to hear about it.


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