Wellness and V70.0

We have a physician office that orders a preventive/wellness panel of laboratory tests. They do this 3 times a year. These claims keep getting denied can you help me explain why and how often these codes can be used?

re: Wellness and V70.0

For lab work, the "special screening" V-codes might work better. Frequency of coverage would be dictated by the payer, and possibly by the group benefits.

re: Wellness and V70.0

Most of the coverage is Medicare Medicaid, this would have an effect, correct?

re: Wellness and V70.0

Definitely. Both are "entitlement" programs. Medicare will not pay for many random "screening" tests wihtout previous abnormal findings or qualifying documented signs and symptoms. You should call your state's Medicaid to verify it's policy.

re: Wellness and V70.0

Thank you

re: Wellness and V70.0

Check out this table- it has codes and frequencies
https://www.cms.gov/MLNProducts/downloads/MPS_QuickReferenceChart_1.pdf