Billing and Coding: Heavy Metal Testing

This billing and coding guidance requires adherence to NCCI and OPPS editing rules and proper reporting of ordering/referring physician information when required. Claims must include a valid ICD-10-CM diagnosis code (and for diagnostic tests, the test result or the symptoms prompting testing) or they may be returned as incomplete under Section 1833(e).

"Procedure codes for heavy metal testing may be subject to National Correct Coding Initiative (NCCI) edits or OPPS packaging edits and must meet those requirements prior to billing Medicare."

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