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I have questions about lead risk assessments. We send our lead testing to the state lab for processing so I know I cannot bill for the lead test itself. I can bill for the HGB draw and also the risk assessment. What I’m wondering is what codes does everyone use for the risk assessments? I use Z13.88 (screening) and 99211-EP. What about the amount to charge? Is it $15.00?
Stephanie, I don’t bill for lead but here is the Mo Health net fee Schedule this is the most they and the managed care will pay..I hope this helps answer some of your questions https://apps.dss.mo.gov/fmsFeeSchedules/maindisclaimer.shtml
I forgot to tell you go to the bottom of page click full search, Medical services, go to blue box put in code and Proc Code… Again I hope this helps.
I wasn’t aware that we could bill anything for the lead if we didn’t test it ourselves “in House”. Curious to hear if this is incorrect.
I spoke with Medicaid yesterday. They did confirm that I could bill for the risk assessment that we do along with the lead blood draw and HGB. (Again, we send off for the lead analysis) SO what I am to bill is the HGB and risk analysis.
I have always used Z77.011 and 83655. I have had some pay and some others not. If anyone know of better codes to use please share. Stephanie I use Z130 and 85018 for HGB. When billing regular medicaid use modifier TC with them if your billing managed medicaid or commercial then drop the modifier. thats what they told me to do and I get most of them paid but the lead test. they dont pay for it often from managed medicaid.
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