Wiki Lexi-Scans and interpretations

[KSanders1983]

Has anyone had trouble with payers paying 78452,26 separately from 93018 and 93016?

I have Magnolia Medicaid and Aetna bundling. There was actually a claim that only had 78452,26 and 93018 and Magnolia Medicaid said 78452,26 is not paid separately.

Any thoughts would be greatly appreciated.


thanks so much!

 

[squidkidroni@aim.com]

You should check your Medicare LCD list to make sure your Dx is a payable one for 78452-26. If the insurance is a Medicaid product it may follow Medicare guidelines. There are limited payable diagnoses associated with 78452-26. Our submissions for 78452-26 along with 93016 or 93018 are usually paid.