Lab Claim Issues - Part B

The Part B Claims Issues Log includes the current status of claim processing issues that have been identified. Novitas is actively working with the necessary areas/entities to resolve these issues. Novitas JL has identified claims that may have inappropriately denied for frequency of services. The impacted codes are CPT codes 82306 or 82652 for subsequent dates of services processed 10/01/2015 through 08/03/2016. Affected claims processed with dates of service 10/15/2015 through 08/03/2016 are currently being adjusted for payment. Novitas JH has found a claims editing issue associated with L35099 (Frequency of Laboratory Tests). It was updated on 06/24/2016 to ensure the frequency of glucose testing is applied regardless of diagnosis. However, upon verifying edits associated with this LCD, Novitas found that some claims for CPT codes 82948 and 82962 have inappropriately paid at a frequency in excess of one per month.

INDUSTRY NEWS TAGS: Novitas Solutions, MAC JL MAC Delaware, MAC JL MAC District of Columbia, MAC JL MAC Maryland, MAC JL MAC New Jersey, MAC JL MAC Pennsylvania, MAC JH MAC Arkansas, MAC JH MAC Colorado, MAC JH MAC Louisiana, MAC JH MAC Mississippi, MAC JH MAC New Mexico, MAC JH MAC Oklahoma, MAC JH MAC Texas

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