ICD-9's that support medical necessity for MBBs

[101N]

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Hey:

Early on in 2011 there was an LCD - Noridian - that implied the only ICD-9 to support medical necessity for MBBs was 724.8. Now it's being denied and it appears they want 721.3. But 721.3 is also what they want for TFESIs. Can any of you shed some light on this.

TIA.

 

[lobelsteve]

Hey:

Early on in 2011 there was an LCD - Noridian - that implied the only ICD-9 to support medical necessity for MBBs was 724.8. Now it's being denied and it appears they want 721.3. But 721.3 is also what they want for TFESIs. Can any of you shed some light on this.

TIA.

Only codes I know that are appropriate are as follows:

721.0 CMBB
721.3 LMBB
720.2 SIJ
723.4 or 722.4 CESI
724.4 or 724.02 or 722.51 LESI/TFESI
733.13 or 805.2 (T-spine) or 805.4 (L-spine) for VCF augmentation
I do not use other codes for these procedures.

 

[lonelobo]

Only codes I know that are appropriate are as follows:

721.0 CMBB
721.3 LMBB
720.2 SIJ
723.4 or 722.4 CESI
724.4 or 724.02 or 722.51 LESI/TFESI
733.13 or 805.2 (T-spine) or 805.4 (L-spine) for VCF augmentation
I do not use other codes for these procedures.

second that, keep it simple lot less denials

 

[101N]

Thanks Lobel.