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Wiki 95018 MMO denials

Thread starter jazzyblues2005
Start date Oct 7, 2014

Create Wiki

jazzyblues2005

Networker

Oct 7, 2014

Is anyone else having trouble with MMO denying 95018 with dx 477.8. According to their policy a secondary dx is required for medical necessity. The secondary dx is a 995.xx code and only 4 of those are approved. Our issue is that not every patient has a problem that calls for one of those codes, but MMO won't pay without it.

Has anyone else run into this?

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