Paper claim rejection for diagnostic test claim

Paper claim rejection for diagnostic test claim

Claims will reject as unprocessable for diagnostic test subject to the anti-markup payment limitations if:

Paper Claims:

 The “Yes” box is checked in item 20, and more than one test is billed on the claim.
Both the interpretation and test are billed on the same claim, and the dates oservice and places of service do not match.
 The “Yes” box is checked in Item 20, both the interpretation and test are submitted, and the date of service and place of service do not match.
 The “Yes” box is checked in Item 20 and the service is billed using a global rather than having each component billed as a separate line item.

Claims will reject as unprocessable for diagnostic test subject to the anti-markup payment limitations if:

Paper Claims:

 The “Yes” box is checked in item 20, and more than one test is billed on the claim.
Both the interpretation and test are billed on the same claim, and the dates oservice and places of service do not match.
 The “Yes” box is checked in Item 20, both the interpretation and test are submitted, and the date of service and place of service do not match.
 The “Yes” box is checked in Item 20 and the service is billed using a global rather than having each component billed as a separate line item.

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