Medicare denials of pre-op blood work
Hi all. Twice in the past few months I've gone for pre-op blood work and gotten the dreaded ABN saying Medicare won't pay for some of the labs. I know this is related to how the lab order is coded. I know lots of folks on here are wizards of medical coding and wondered if anyone would be willing to share what I should look for in future to nip this problem in the bud. Is there generic coding that something is pre-op? Or is there coding specific to the procedure that is planned? As an example, this morning I had labs drawn and the ABN states they will not cover prothrombin time or the urinalysis. The coding on the lab work was the ICD10 N.30 – for bladder neck contracture. But no coding indicating that I'm having reconstructive surgery for it in two weeks. Really appreciate any input. And I will cross post in the Medicare forum if no responses here, but in my experience the folks here seem much more proficient in coding.
submitted by /u/bobsatraveler