wilsontheresa@optonline.net
Contributor
Hello All,
Our derm is billing 11055 paring of corns/calluses to Medicare and it is being denied. The LCD is a bit confusing for NY. Am I reading this correctly? MUST the patient have an underlying condition with approved diagnosis code(s) from Group 1 OR have some form of neuropathy condition as per the Group 4 diagnosis codes? Our patient has SLE Systemic Lupus Erythematosus and presented to the doctor with other dermatological conditions including painful corn/callus on right foot. We billed with L84 and M79.674 for pain in right toe(s) but Medicare is denying for medical necessity specifically citing the LCD. Can anyone provide any insight? Thank you!
Our derm is billing 11055 paring of corns/calluses to Medicare and it is being denied. The LCD is a bit confusing for NY. Am I reading this correctly? MUST the patient have an underlying condition with approved diagnosis code(s) from Group 1 OR have some form of neuropathy condition as per the Group 4 diagnosis codes? Our patient has SLE Systemic Lupus Erythematosus and presented to the doctor with other dermatological conditions including painful corn/callus on right foot. We billed with L84 and M79.674 for pain in right toe(s) but Medicare is denying for medical necessity specifically citing the LCD. Can anyone provide any insight? Thank you!