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alyssak88

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Litchfield , CT
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Hi, I am working on a claim for G0328 COLORECTAL CANCER SCREENING; FECAL OCCULT BLOOD TEST, IMMUNOASSAY, 1-3 SIMULTANEOUS. The diagnosis used was a screening V7641. The first test was done and results were abnormal. We did a second test to confirm and again results were abnormal. It was billed again as a screening V7641 and Medicare denied it, which makes sense because only one screening is allowed per 12 months. I do not think the second one should of been diagnosed as a screening test becuase we already knew from first test that results were abnormal. Does anyone know what diagnosis code to use in a case like this? Oh and if anyone is wondering an ABN was not signed by patient! Thank you.
 
We've had repeats come through and had no luck getting Medicare to cover but you could try using the code for abnormal lab findings and see if that gets it through. This is one reason ABN's are SO important!!
 
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