Wiki 86800 - Humana diagnosis denials - Need help!

[vidraj]

Hi everyone,

Is anyone facing the diagnosis denials for your practices for the CPT - 86800 from Humana, Humana Medicare?

We have been submitting claims with the E03.9 - Hypothyroidism, unspecified

How to resolve these?Any suggestions.

 

[Papitha]

I do not face the denials; However, as per my review of Humana policies CPT 86800 is only reimbursable during pregnancy. Please check with the respective payer if they follow some state / facility specific rules / guidelines.



I have provided the link below for your reference.

file:///C:/Users/GB17176/Downloads/Laboratory%20-%20Thyroid%20Disease%20Testing.pdf



Hope this helps!

 

[vidraj]

Thank you for your reference.
This helps me to look further.