Wiki Code 11055 nmn by medicare

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DEBTRU

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Hello i am new here and new to family practice billing. I am in az. Medicare denied a 11055 (corn removal) when billed with exam. Dx for the corn was 700. The exam had 3 other seperate dxs. Medicare says: Not medically necessary. Is this because we should not do such procedures on the same day as an extensive exam?
 
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I would suggest starting by locating and reviewing your local Medicare MAC carrier's LCD for the CPT code 11055 and specific coding guidelines. It will give you directions and indications as to how to bill it after determining the medical necessity. Routine footcare is not a covered service and you did not share what the other diagnosis were that may lead to an indication why the patient required a physician to removed the corn.
 
thank you

I am in AZ, and looked up the LCD and ho boy you are right, basically no coverage for routine foot care unless you have a very specific situation. Thanks for the help
 
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