Tara0513
Networker
I am hoping someone out there can guide me in the right direction. I work for an independent laboratory where we process specimens for respiratory (bordetella), women's panel (STI, bacterial vaginitis, lactobacillus, etc), diarrhea pathogen panel along with additional tests (H-pylori and listeria). We have been using 87798 for some of the stated testing, and now Horizon BCBS, Aetna and Humana have been denying our claims straight out or requesting medical records before paying. It has become a full time job to send the medical records (we don't have anything but a requisitions and the referring providers will not send out medical records for us), to the point that we might need to hire more employees just to handle the volume of medical records request. Just wondering if anyone else has been hit with this issue? If so, have you had any luck with getting the claims processed? Is there anything we should be doing differently? Maybe we are using the wrong cpt code? I have researched all codes, and looked up each medical policy and I can not find where this code is an issue.
I appreciate any feedback.
I appreciate any feedback.