This is true in GA too. Our medical director has contacted the local review
board, but we have no changes yet. I thought it was just our region or I
would have alerted everyone last year when I discovered it!!!  I have a
feeling now, that is it nationwide. We need to check with the Medicare
powers that be to get this changed. We have an inventory of 75 + antibodies,
and no Medicare reimbursement for any except Her2Neu. What a mess! j

Joyce Weems
Pathology Manager
Saint Joseph's Hospital of Atlanta


	-----Original Message-----
	From:	Willis, Donna [SMTP:DonnaWillis@texashealth.org]
	Sent:	Monday, May 21, 2001 5:28 PM
	To:	'HistoNet'
	Cc:	Stengel, Gaylene
	Subject:	Complynet

	Good Afternoon to All:

	Is anyone out in Histoland using the Complynet system to check for
medical
	necessity.  We are having problems in that the only 88342 CPT codes
that the
	Laboratory Medical Review Policy (LMRP) are accepting are ones that
have
	ICD-9 codes of 1740-1746, 1748-1749, 1750, and 1759.  These are the
ICD-9
	codes listed under the LMRP for Her-2/neu.  Is anyone else having
their
	88342 CPT codes rejected by insurance companies?

	Thanks,
	Donna Willis
	Histology Lab Manager