Claims will reject as unprocessable for diagnostic test subject to the anti-markup payment limitations if:
Paper Claims:
The “Yes” box is checked in item 20, and more than one test is billed on the claim.
Both the interpretation and test are billed on the same claim, and the dates oservice and places of service do not match.
The “Yes” box is checked in Item 20, both the interpretation and test are submitted, and the date of service and place of service do not match.
The “Yes” box is checked in Item 20 and the service is billed using a global rather than having each component billed as a separate line item.
Paper Claims:
The “Yes” box is checked in item 20, and more than one test is billed on the claim.
Both the interpretation and test are billed on the same claim, and the dates oservice and places of service do not match.
The “Yes” box is checked in Item 20, both the interpretation and test are submitted, and the date of service and place of service do not match.
The “Yes” box is checked in Item 20 and the service is billed using a global rather than having each component billed as a separate line item.
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