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Dec 5th, 2018 - Denise J   

Ordering and obtaining precert/prior auth for Motility Studies @ the hospital

Quick question. We are having trouble with getting the correct codes for our Motility studies. We are now running in to the problem of having our Motility studies needing to be precerted or needing prior auth. We only charge for the interpretation of the study, so the code we use is 91010-26. The hospital is getting precert for the cpt code 78258 which is under Nuclear Radiology: Digestive system, along with cpt code 91299 which is unlisted diagnostic gastroenterology procedure; and is ultimately being denied. The hospital representative told our nurse that we should be ordering and precerting for the Radiological code as well as the interpretation code. How is everyone handling this, and are you getting auth for Radiological code as well as interpretation codes??

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