MEDICAL REVIEW UPDATE
DENIALS FOR LABORATORY SERVICES
Recent analysis of denied laboratory services has established a trend of increasing denials resulting from claims processed with services included in the following Local Medical Review Policies:
While blood glucose, blood counts, and prothrombin time are specifically mentioned, this bulletin serves as a reminder to carefully evaluate the Local Medical Review Policies for all services in an effort to assure accurate, comprehensive coding, and ultimately ensure prompt reimbursement for medically necessary services. Decreasing the denial rate also eliminates the cost incurred by both the provider and Intermediary in the appeals process.