We are having problems with Medicare requesting refunds for CPT 88305-TC and 88305 using the reason the patient was in a outpatient hospital. We believe this is happening because the edit logic is checking against the referring physician listed on the claim. In the past we named the actual physician who referred to our clinic. We fixed the problem on our end and have started listing our physician as the referring physician for CPT 88305. The problem remains on the previously denied claims, Medicare denied our appeals and we were told a mass adjustment would be done but it did not capture the claims that had the wrong referring physician. We have tried redetermination, reopening, and refilling, to list our physician as referring and to have claims reprocessed without success. Any suggestions?