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Medical Necessity Checking

Last modified by  IMarrero  on  January 10, 2012 04:08 PM


UNC Hospitals
McLendon Clinical Laboratories
101 Manning Drive
Chapel Hill, NC 27514
 
  • Determine patient diagnosis.
  • Record the diagnosis code(s) in the appropriate space on the requisition form. ICD-9 codes are required. 
  • Check the limited coverage test list below to determine whether the test is listed.   If the test is not listed, no further action is required. 
  • If the test is listed, click on the test and check the ICD-9 code provided with approved codes listed within the test coverage policy. If the ICD-9 code is listed, no further action is required. 
  • Special Note: The reverse is true for the CBC coverage policy. The CBC policy lists codes that do NOT justify medical necessity.
  • Note: If all individual test of a panel are ordered, the lab will bill Medicare for the panel.
 
 
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