Wiki 80053 - Mcare denial

[lirby2005]

Does anyone received any denials from Medicare about 80053? We've been receiving denial as it exceeded the amount of service. Do I have to include any modifiers or something? Need help please.
Thank you all.

 

[AllisonMorani]

While most commercial insurance companies pay for 80053 Medicare may want to know the specific tests that were done. Try coding the actual tests that were done without bundling them into the one code CPT- 80053 metabolic panel. Im pretty sure it is 3 or 4 codes and make sure you point them to the correct diagnosis. I know when I worked for Internal Medicine that is how we coded it.

 

[lirby2005]

Thank you, this will help.