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A. Schuyler, NP
A. Schuyler, NP, Nurse Practitioner
Category: Health
Satisfied Customers: 16164
Experience:  Board Certified NP, MS, RN. 25 years private practice & hospitalist
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Hello. My physician ordered loads of bloodwork and the Ferritan

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Hello. My physician ordered loads of bloodwork and the Ferritan test and Iron Binding test were denied by Medicare. I am not even sure why they wwere done and how I can justify them. My physician me these codes:280.9, 780.79....Will this fly with Medicare. They also are denying the CA125 test....Any ideas?Thanks

Hello,

Answers provided are for informational use only and do not confer patient-provider relationship. My name is XXXXX XXXXX I will help you.

 

The code 280.9 is for iron deficiency anemia, unspecified and 780.89 is "other malaise and fatigue."

 

Why would he order a CA125 test? Are you being treated for cancer? That is the most common use - to monitor treatment, or to check for a recurrence of previously-treated cancer. It isn't specific enough to diagnose anything. Your doctor will need to help you with the rationale of ordering each of these tests when you appeal the denial. There is no generalized reason unless there was a prior test that showed low RBC and low hemoglobin.

 

Best regards,

 

Schuyler

 

Customer: replied 3 years ago.

I c/o feeling exhausted especially in the AM. I am dxed with CFIDS...So the codes should justify the testing?


Oh, the CA125....I asked for this because of severe pain in right ovary for almost half a year . I was scared to death of having CA because I never had kids. Should they pay?Thanks

They won't pay for the CA125 because it isn't diagnostic for ovarian cancer. An ultrasound would have been a better choice.

 

If the diagnosis is chronic fatigue, that won't justify a test for iron. Only a CBC with differential would give the numbers necessary to diagnose one of the anemias, and then the iron tests would be ordered to determine if it is iron deficiency anemia, thalassemia or something else.

 

Best regards,

 

Schuyler

 

Customer: replied 3 years ago.

ok,thanks....So they should not have been all ordered together?If these were normal ,can I give blood?

If your hemoglobin is normal you can still give blood.

 

Best regards,

 

Schuyler

 

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