Who is to blame for this error

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Assignment:

A patient was presented to the doctor for drug testing for new employment. The doctor asked the patient for a urine sample. The doctor performed a urinalysis. The patient was tested for: alcohol, cocaine, and metabolites. The coder reviewed the medical documentation and assigned the following CPT codes and ICD 10 diagnosis codes below. The medical biller verified the patient insurance coverage and affirmed new employment drug testing is covered and submitted the claim for payment. The charges billed were denied not medically necessary by the patient's insurance company for payment.

Review the codes below using your coding books and answer the questions below.

CPT: Office visit code: 99213 Labs codes: 82040, 84075, 84460.

ICD 10CM: Z02.1

  • Based on your knowledge gained and information from the coding books, explain what specifically caused the claim to deny for non-medically necessary?
  • Who is to blame for this error? (The coder or the medical biller) and what steps can be taken to stop this from happening again?

Reference no: EM133502288

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