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Kristimo

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Need some help with the following scenario: Pt came in Dec. 2014 for Well Woman. She did not require a PAP as she has had a hysterectomy w/cervix removal. At end of exam she mentioned she would like allergy testing as well. Pt's insurance did not cover 99386 because a PAP was not performed. Pt is requesting that we change the CPT code to reflect just allergy testing. Anyone have any ideas on where I can find definitive legal guidelines for this?Suggestions?
 
Under the ACA preventative exams have to be covered, I'm fairly certain. CPT descriptor doesn't even mention a pap. (I didn't have a pap and mine was paid no problem, just last month.)
Is the issue that she also had allergy testing at the same time? I would appeal the denial.
 
Thanks for responding. Yes I believe you're correct about the ACA preventative coverage. I have been doing some research and will definitely appeal. No issue with the allergy testing.
 
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