any medicare denials for RFNs requiring correct ICD 10 codes?

[spinal]

We have had some denials about lumbar RFTC procedures. Asking for the correct ICD-10 codes? Submitted both lumbar and lumbar-sacral spondylosis ICD-10 codes ( M47.816 and M47.817) since we did the L3-4; L4-5 and L5-S1 levels. Not sure what else they need. Any thoughts?

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[txbackdoc]

that should do

 

[spinal]

that should do

 

[spinal]

That did not do it. I will try M47.896 and M47.897 which stand for: other spondylosis lumbar region and other spondylosis lumbar-sacral region respectively. Anyone please feel free to share your experience with this issue.

 

[Ducttape]

are you sure it is not because you did 3 levels at one time?

 

[spinal]

are you sure it is not because you did 3 levels at one time?

why? I thought that the most we could do was 3 levels. Has that changed recently? Should we do less than that now days?

 

[jj337]

Attended meeting with billing expert who said L5-S1 facet should be billed lumbosacral spondylosis and each one higher should be billed lumbar spondylosis. However, she also said Medicare was going to give everyone a break for a year...

 

[SSdoc33]

why? I thought that the most we could do was 3 levels. Has that changed recently? Should we do less than that now days?

depends on your LCD

 

[Ducttape]

Some LCD will only allow 2 levels one side at one session or 1 level bilaterally