tadailey
Contributor
I've been receiving denials for patients PSAs with Z85.46 (personal history of prostate cancer). Some commercial insurance companies, including BCBS, is considering this as routine services and is patient's responsibility. I don't understand how this is considered routine services and what is the best course to appeal this denial. I cannot change the diagnosis code to C61 because the patients have received treatment, ie; prostatectomy, HDR, and there is no evidence of disease and is not being actively treated for prostate cancer and my physicians are only monitoring the PSA. So my question is how can I fix this??
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