# Trigger points



## robreed840 (Jun 9, 2010)

Anyone having problems getting paid if that is the only code submitted to ins? Example would be 99213 - 25
                               20552
Where can I find info for proper diagnosis that is exceptable?


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## RebeccaWoodward* (Jun 9, 2010)

Medicare has a LCD for this procedure.  You can search for your LCD by state.  

http://www.cms.gov/mcd/viewlcd.asp?lcd_id=6168&lcd_version=18&show=all

Above is NC's


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## mitchellde (Jun 9, 2010)

robreed840 said:


> Anyone having problems getting paid if that is the only code submitted to ins? Example would be 99213 - 25
> 20552
> Where can I find info for proper diagnosis that is exceptable?



The proper dx is the one documented by the physician.  The LCD will tell you if that dx is acceptable as a covered dx.


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