# Denied to "dx is inconsistent with procedure"



## minoweka (Oct 22, 2012)

Patient is MediCal (Medicaid-California) with pregnancy/post partum related eligibility only.

We have billed 99212 / 646.63.

MediCal is denying to "dx inconsistent with procedure". 

The dx is ante-partum related. I can not determine what else MediCal is looking for. Any ideas? 

Thank you.


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## mitchellde (Oct 22, 2012)

I am not sure could be you need a urine culture?  or possibly the are wanting the 599.0 as a secondary dx code?


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## minoweka (Oct 22, 2012)

Hi Debra,

Thank you for your response. 

We did perform UA with 599.0, was paid. However, we did not bill the E&M with both dx (646.63/599.0)

I will bill 99212 with both dx. 

Thank you so much.


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## mitchellde (Oct 22, 2012)

Ah  that is the problem.. technically you do not bill these 2 together as that is redundant so the culture should have been the 646.63 also that is why it is inconsistent, you have a culture saying not pregnant and a visit saying pregnant.  the additional dx code the 646.63 is looking for is the culture result.


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