# Medicare denied CPT 81000



## neha.bhatnagar (May 14, 2010)

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.. 

Thanks..


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## bill2doc (Sep 3, 2010)

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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## Stefanie (Sep 14, 2010)

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.


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