Laboratory Question for the Week of May 16, 2016

Laboratory Compliance Question of the Week

Question:

Our MAC is denying many of our dialysis claims that include screening for sexually transmitted infections with dates of service (DOS) in September 2015. Are you aware of any system problems that would cause this? 

Answer:

Dialysis claims with DOS prior to October 1, 2015 that include screening for sexually transmitted infections, are being denied in full instead of at the line level. Medicare administrative contractors (MACs) are updating their systems to correct this problem and will reprocess denied claims (72X type of bill; HCPCS code 86631, 86632, 87110, 87270, 87320, 87490, 87491, 87800, 87810, 87590, 87591, 87850, 86592, 86593, 86780, 87340, or 87341; diagnosis code V74.5 or V73.89).

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.