MC REIMBURSEMENT FOR OV CPT CODE 99396

[Guest guest]

Hello

I have donor who had an office at OB GYN group and they

billed for bloodwork done, obtaining pap smear and office visit code 99396. I

don’t see from the MC Prof Fee schedule or using CMS online HCPCS tool

for reimbursement, that the 99396 is a payable by MC (the status indicator is

E- which is defined as “not paid under OPPS”- Outpt Prospective Payment

System).

Before not reimbursing the amount charged based on the

99396 cpt code, does anyone know if MC will pay?

Thanks

McIver

Renal

Services Financial Counselor

Summa

Health System

Office

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Fax

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