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EDITOR'S WELCOME

In the coming months, laboratories will be subject to more and more computer edits concerning Medicare and Medicaid claims.The implementation of NCDs as well as new rules concerning code modifiers and other issues will demand that laboratories take even greater care when submitting claims. This week we will explain how to avoid a common problem, denials that result from using the same CPT code more than once on a Medicare or Medicaid claim. Keep the suggestions, comments, and questions coming.

Sincerely,

Charles Root, Ph.D.

USING THE SAME CPT CODE MORE THAN ONCE FOR LAB TESTS

Using the same CPT code more than once on a claim can result in denials of the subsequent codes because the Medicare Carrier thinks they are duplicated services. There are many instances where the same CPT code is properly used to describe either different tests or the same test more than once on the same date of service. In many cases the second and subsequent codes may be denied as a "duplicated service" unless they are used with the proper modifier. The date of service for ....

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