lab denials

  1. J

    Wiki Payable Diagnoses

    Hi all! A friend who works for a nephrology office in NY has asked for my help looking for coverable diagnoses for some labs her doctor routinely orders. They're finding that these labs are getting denied when they're done by Quest, for patients with Medicare. I've looked for LCDs and NCDs on...
  2. Q

    Wiki Provider Signature

    Hi I need clarification when it comes to physician signature when ordering laboratory testing. Do we need the actual signature from the doctor or electronically signed showing the provider's name including their credentials will be sufficient? Also, when it comes to Toxicology if the Laboratory...
  3. S

    Wiki CLIA #

    We have a current patient on Accutane with UHC and they keep denying her HCG stating that our CLIA certificate level is PPMP and the codes certificate level is "waiver.". We were advised to have our certificate level changed to "Waiver". I just don't think this is correct, our CLIA certificate...
  4. J

    Wiki Receiving Lab denials from UHC when using Z codes

    Hello! I have been noticing an issue with United HealthCare where they are denying our lab claims for medical necessity if the first dx is a Z code. The lab charges vary but I tend to see that a lot of the time labs such as CBB w/ dif, Lipid panel, and Hemoglobin A1C are the ones being denied...
  5. M

    Wiki 86592 Chlamydia

    A patient was seen at our family care office. He had been told by the health dept that he may need to be treated a second time for chlamydia. Our dr ordered 86592. Test results were negative. Am I able to code z11.3 since we are looking for the infection again? If not, what can I use? I...
  6. L

    Wiki Changing diagnosis on denied lab tests

    Any help would be greatly appreciated. If a patient is seen and the provider orders 4 lab tests and documents 2 diagnosis for the visit. Lets say 2 of the labs pay and 2 deny due to non covered diagnosis. If the patient was previously seen (say with in the previous 30 days) and there is a...
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