OT.. Medicare denial .. good news and thanks

Thank all of you who gave me good tips on why Medicare might have refused a few of my post surgical labs. I finally after hours on the phone with Medicare reached someone who actually helped me.  The problem is with my surgeon's office as they did not code properly in all likelihood. So I have informed the surgeon's office of this problem and the fact that they need to explain to Medicare why I need to have this done in order for it to be covered.  

Poet Kelly, you were right again!  It is no doubt the coding.

Keeping my fingers crossed that this all gets straightened out.

If nothing else, it pays to be persistent when dealing with the insurance companies and Medicare.  I am learning to just thank some of the reps for their time and hang up and move on to the next one if the one I am dealing with is not helpful.  

Glad you were able to reach someone that was actually helpful.

I know there is a code for "surgical malabsorption" and there is also a code for "intestinal malabsoption" or something like that, a code that doesn't indicate that the malabsorption is due to surgery.  If you previously had any deficiencies, there are codes for that, too, like a code that means "iron deficiency" or "B12 deficiency" which would explain why you need  that particular test done at this time.   I'm pretty sure there are codes to use if you have symptoms of any deficiencies, too, like if your B12 level was OK last time you had it checked but now you have symptoms of B12 deficiency, that would be a reason to get that particular test done at this time.  I also know my PCP has used more than one code when ordering labs, like she has put down the code for surgical malabsorption AND the code for vitamin D deficiency.  I'm not sure which code or codes are most likely to get the labs covered, but it seems like whoever is in charge of billing insurance at your doc's office ought to know that.

Kelly, excellent advice and I will pass it on to billing at the surgeon's.  It seems you cannot have enough codes anymore to cover what is going on.

I heard that there is now actually a code for if you get burned while your water skis catch on fire.  I kid  you not.  Unreal.

Again, I will pass this valuable info on and thank you.