# Knee manip/under anesth denied



## bethebest7 (May 6, 2010)

I am looking for help with this scenario:
My doctor performed a knee manipulation under anesthesia (27570) for Arthrofibrosis of the knee.  He used the DX 715.16. The claim was denied by UH for "unproven for the dianosis billed and is not a covered expense. There must be scientific evidence submitted.....that demonstrates the safety and effectiveness of this service....."

Any suggestions?


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## nyyankees (May 7, 2010)

bethebest7 said:


> I am looking for help with this scenario:
> My doctor performed a knee manipulation under anesthesia (27570) for Arthrofibrosis of the knee.  He used the DX 715.16. The claim was denied by UH for "unproven for the dianosis billed and is not a covered expense. There must be scientific evidence submitted.....that demonstrates the safety and effectiveness of this service....."
> 
> Any suggestions?



Did you check the insurance co's website to see what their policy is on this code? I would first start there.


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## lisaestelle (May 7, 2010)

Try Dx code 718.56 which is the correct code for Arthrofibrosis of the knee. This should work 715.16 is for osteoarthritis


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## bethebest7 (Jun 18, 2010)

*thanks*

Made some adjustments and also sent them a copy of the payors policy.  Thanks for the help!


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