Telephone Reopening: Requests Containing MolDX Services No Longer Accepted

Effective immediately, claims containing the below procedure codes now require documentation be submitted with their Reopening request and will no longer be corrected via a Telephone Reopening.

• Molecular Diagnostic (MolDX): 81200-81383, 81400-81479, 88380-88381, G0452, 81479, 84999, 85999, 86849, 87999, 88199, 88299, 88399, 89398, 83890-83914, and 88384-88386

When documentation is required to process a Reopening, providers must submit the request as a Written Reopening with a completed “Reopening Form” or through Endeavor. If a request is more complex, beyond clerical errors or omissions, it is appropriate to submit a Redetermination via the “Redetermination Form.”

MAC JF for Arizona, Alaska, Idaho, Oregon, Montana, North Dakota, South Dakota, Utah, Washington, Wyoming
MAC JE for California, Nevada and Hawaii.

Source: https://www.noridianmedicare.com/cgi-bin/coranto/viewnews.cgi?id=EFlkpFFVuEffACtpVJ&tmpl=part_b_viewnews&style=part_ab_viewnews