tci Outpatient Facility Coding Alert - 2019 Issue 5
Reader Question: Avoid Denials, Check Code’s LCDs, ICD-10-CM Crosswalk
Question: We received a denial for code 92511 for due to an incorrect diagnosis code. The diagnosis codes we reported are H69.91, J30.89, and Q67.4. The patient’s chart also documents nasal congestion. Should I resubmit the claim with a nasal congestion diagnosis or appeal with the current diagnoses? Indiana Subscriber Answer: You can check a CPT® code and ICD-10-CM code’s compatibility two different ways. First, you can check your Medicare Administrative Contractor’s (MAC’s) Local Coverage Determinations (LCDs) for code 92511 (Nasopharyngoscopy with endoscope (separate procedure)). Another option is to check the ICD-10-CM...
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