This section excludes routine physical examinations. This section allows coverage and payment for only those services that are considered to be reasonable and medically necessary. This section prohibits Medicare payment for any claim which lacks the necessary information to process the claim.
Diagnostic codes are to be used at their highest level of specificity.
Fourth and fifth digits should be utilized when they are available. EMC and hard copy claims will be monitored for appropriateness and frequency. CME Clinical Laboratory Workgroup 2. Use of V82.9 or comparable narrative will result in the denial of claims as non covered screening services. All ICD-9 diagnosis codes must be coded to the highest level of specificity.