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Wiki 91038 Esophageal function test

Thread starter Nancy Klein
Start date Mar 11, 2014

Create Wiki

Nancy Klein

Guest

Mar 11, 2014

Hello,
We billed a Medicare Advantage carrier for an Esophageal Funtion Test 91038 with a diagnosis of 783.21 (loss of weight). The claim denied as a non-medically necessary diagnosis. The carrier states this is a CMS policy guideline; however, we were unable to locate any diagnosis restrictions. Does anyone know of any CMS policy for this procedure?

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