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  1. M

    Wiki C0172 Denials for Pathologists

    Also, we are a specialty group with ASC's. These pathologists work for us.
  2. M

    Wiki C0172 Denials for Pathologists

    Hi Dana, Weird thing is they process 50% of the claims with no problem. Then they default back to a provider who has not been with the organization for 10 yrs. We are also billing globally. We own the lab and services are being ordered and done in our offices by our providers.....
  3. M

    Wiki C0172 Denials for Pathologists

    Hi Thomas, Thank you for your feedback. Cigna is stating its a CMS policy that they are following yet, we own the lab and bill under the pathologist. Medicare reimburses our claims. So, I am thinking it has to do with how they are credentialed in the system. Weird thing is its random, some...
  4. M

    Wiki C0172 Denials for Pathologists

    Thank you this is a payer issues, Cigna was not processing the claims correctly, we were submitting correctly, but they were keying claims incorrectly. Thank you for your help.
  5. M

    Wiki Pathology Claims Denied By Insurance

    Looking for anyone getting denials on pathology codes by Cigna Provider specialty code not valid for this type of service (CO-172) We own the lab and we bill other payors without denials. Sample code: CPT 84153 Any advise would be helpful. Thank you
  6. M

    Wiki C0172 Denials for Pathologists

    Good Morning All, Anyone experience denials for billing diagnostic labs codes (Example 84153) by a pathologist?
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