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Wiki 87811 rapid covid testing

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gpugh0501

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Youngsville, NC
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Is anyone having problems with getting 87811 paid by NC Medicaid and the new PHP plans?
Some claims pay the nurse visit for the collection but not the test...others dont pay either code. I cannot find any logic in their random denials
 
gpugh0501 said:
Is anyone having problems with getting 87811 paid by NC Medicaid and the new PHP plans?
Some claims pay the nurse visit for the collection but not the test...others dont pay either code. I cannot find any logic in their random denials
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I was told that Medicaid is still working on updating the codes in their system for rapid tests. Once they get them updated we will have to either call on the claim or send the claim back in. You might want to call NC Medicaid and see if they have the code you are using updated in their system. As far as the logic behind Medicaid denials there is absolutely none lol. I have been doing this for over 25 years and I still can't figure out why they do what they do.
 
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