# 835 Healthcare Policy Identification Segment



## vmounce

I have a claim that denied for not deemed medically necessary, and to refer to 835 Healthcare Policy Identification Segment.  I have never seen one of these before.  Does anyone know what it means?  Doc removed 2 lesions, one on each eyelid.  Used 216.1, 11442 LT and 11441 RT.    

I appreciate any info...

Vickie Mounce


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## jkirasich

We have been wondering the same thing.  Has anyone else encountered this mysterious denial?  Upon researching it looks as though it is the name of a list of denial codes, but I can't seem to find any other information.


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## QueensCoder

*Mysterious denial*

" Refer to the 835 REF Segment: Healthcare Policy Identification, if pr"


It seems  that the denial explanation its truncated and we don't see the whole explanation. ...... I think that is what they want to say ....not medically necessary????  I thought that you can say that when behind your last name you write M.D. Who determines that?


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## smiffer

just got off the phone with medicare about the same denial, rep stated that it was submitted incorrect. if a medicare recipient has disability the claim needs to go through with a 43 code and not 47 code which is a liability code. It may be different in each state so give medicare a call.


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