[Ohioaap-practicemanagers] CareSource denials of rapid strep tests

[Michael Chamberlin]

We are getting denials for rapid antigen strep testing (87880) when using
"acute pharyngitis, unspecified J02.9."  The guidelines say that if viral
pharyngitis is suspected then a rapid strep test should not be done so I
would understand a denial of the claim if "viral pharyngitis" is used.  We
may try using the ICD 10 code for "pain in throat" but it is silly that we
have to guess at what is the appropriate code to use for this.

Has anyone else experienced this before?  What ICD 10 code do you link with
a rapid strep test?

Mike

Michael Chamberlin, M.D., FAAP
Pediatric Assoc. of Mt Carmel
4371 Ferguson Dr
Cincinnati, OH  45230
513-752-3650
513-752-3387 (fax)
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