Wiki INR testing

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desertsteph65

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We have an issue with state medicaid on payment of INR testing. We have our CLIWA cert and we have been charging an office visit plus G0434-QW. State medicaid has denied our claim stating thatPro0cedure restricted to Medicare eligible members only. So we tried office visit with 99363 and they again denied it stating Code B is not payable with the service combination billed/paid. They paid for the office visit but not the test. Any ideas would be greatly appreciated.
S. Walters CPC:eek:
 
Inr

my thoughts exactly. Also, in one sentence, you reference Medicaid and the other Medicare. Medicare pays the full allowed amount of lab testing, so there shouldn't be a balance to medicaid.
 
inr

we have a clinic that is run by NP who does INR testing and management of the coumadin. She charges an OV plus G0434QW. It is our state medicaid that is denying the test and they paid the office visit. On the eob they stated that G0434QW is only paid for Medicare eligible members. So we tried the 99363 code and that came back denied with Code B is not payable with the service. I was just wondering if anyone had any other code that we could use to get paid for the inr test
 
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