denial for elevated PSA

Has anyone received denials for elevated PSA using 84153 and R97.20 for not being medically necessary?

Nancy A. Giffin, CPC-CUC
Swedish urology Billing
206-224-7286

Comments

  • Not yet but their 10.1.16 update to the lab manual did not include this new code. Still has R97.2 listed. That’s not good.

    Second error I found this week. They never added new code pre-diabetes to the covered list for the A1c. I posted about that yesterday.

    From: Nancy Giffin [mailto:nancy@swedishurology.com]
    Sent: Friday, October 21, 2016 2:59 PM
    To: Multiple recipients of list PARTB-L
    Subject: [partb-l] denial for elevated PSA

    Has anyone received denials for elevated PSA using 84153 and R97.20 for not being medically necessary?

    Nancy A. Giffin, CPC-CUC
    Swedish urology Billing
    206-224-7286
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