BC Advantage - 2016 Issue 4

BILLING TIP - COVERED SERVICES

The following is a question asked on the Medical Association of Billers' forum: "I have been receiving LCD (LCD L34325) denial from Medicare for Autonomic Nervous System Testing (ANS) claims stating that "These are non-covered services because this is not deemed a 'medical necessity' by the payer". I used limb pain, hypertension, shoulder pain for these claims and I was getting paid with ICD 9 codes but Insurance keeps denying same diagnosis with ICD 10 stating above reason. Can anyone know what the appropriate diagnosis codes (LCD L34325) based on Noridian Medicare? We are not given sufficient information to...

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