Forum - Questions & Answers

Sep 15th, 2010 - crystalj

Denial from MediCal

We are receiving denials from MediCal for CPT codes 84460, 82947, 84295, 84550
83615 stating "Reimbursement amount prorated for automated chemistry test" Is there a solution to this denial other than taking an adjustment

Thanks in advance

Sep 15th, 2010 -

Nope

Do you actually perform each test separately and not as a panel? If it is Medicaid/MediCal I would look closely at reimbursement to be sure you are covering your cost. I think they are seeing that a CMP would include the liver test, Glu and sodium so they bundle, the other two are not part of a panel so should be paid separately.



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