Wiki 20550 Medicare Denials

[physiciands]

We are seeing a lot of denials for injection code 20550. Has anyone else had this issue? We never used to have a problem getting paid, but now we are. I have appealed to Medicare on several claims and awaiting determination. But, we just received more denials this week. Any help is greatly appreciated!

 

[mitchellde]

what does the denial reason state?

 

[dclark7]

Have you checked for an LCD? NGS Medicare has one for this code and there are only 48 diagnosis codes that are covered.

 

[ollielooya]

I side with Doreen on this one. There were some changes when we moved from WPS to NCG and the recent revised edits on the LCD's affected us big time in some of the codes we were submitting and generated substantial denials. You might want to dig into this more.