Author Topic: Medicare denies STD Risk Factor :(  (Read 902 times)

Shakthi

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Medicare denies STD Risk Factor :(
« on: November 06, 2015, 03:13:12 AM »
Can someone help on this ( Pt came in for STD risk factor ) Billed with ICD 10 Z11.3 denied as This is a non-covered service because it is a routine/preventive exam or a diagnostic/screening procedure done in conjunction with a routine/preventive exam. :'(

Pls advise with an suitable ICD 10 code :-\

Michele

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Re: Medicare denies STD Risk Factor :(
« Reply #1 on: November 06, 2015, 07:42:43 AM »
You have to be careful.  You cannot pick an ICD10 code strictly based on whether it will get the service paid or not.  You have to pick the ICD10 code based on what is in the patient's chart.  If the patient came in strictly to be screened and the plan doesn't cover that then there is nothing that can be done.  If the patient had any symptoms that would warrant a different dx then you could submit a corrected claim.
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