Question:
I am performing a crystal analysis of synovial fluid by microscopy but Medicare is not paying my claims. How do I code this procedure to get paid?
Answer:
Crystal identification by light microscopy with or without polarizing lens analysis, any body fluid (except urine) should be coded 89060. CLIA categorizes this test as a high complexity procedure due to the technical proficiency required in the interpretation of the sample. Since CLIA classifies this procedure as high complexity, your office must be certified to perform these procedures and will be issued a CLIA number indicating your proficiency level. When filing claims with Medicare for laboratory procedures performed in the office, a CLIA number is required to be submitted with each claim before they are paid. Your claim will be denied if: a) you do not included a valid CLIA number with your claim. b) the CLIA number included isn’t for a high complexity laboratory but for some other level of certification, i.e. waived, PPM, or moderate.
