Wiki Cross codes

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Lebanon, PA
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Can someone help me with a cross code question. I new to coding and I was told I can use encoder pro to check cross codes. This will tell me what dx codes can be used with cpt codes? If that is the case, it tell me that any sinus symptoms or sinus diagnosis codes can’t be used with CT sinus 70486. How can that be??
 
in EncoderPro, instead of looking at the "crosswalk", look at the LCD/NCD for the cpt code.

search 70486 and click on the code.
on the top left under "medicare reference", click "local coverage determination" and then click your MAC (or if your MAC is not listed, click on another to see the info, if you want).
then click on the little "+" and it will expand the LCD and show you the billing and coding article.

I just did this and I see that the sinusitis codes are covered.

I hope this helps. and I hope you have access to the LCDs. I don't know the different levels of EncoderPro subscription include.
 
I'd just add that this information tells you what diagnosis codes support medical necessity per certain payers' policies. They don't tell you what diagnosis codes can or cannot be used with any given procedure code. You always have to use the diagnosis code that is correct for reporting what the physician has documented whether or not it is on a particular list of codes that a payer will accept. The purpose of these lists is to help you understand what codes support medical necessity so that you can educate your providers or query them for additional information about why they wanted to perform a service - they aren't for telling you what you can or cannot use.
 
in EncoderPro, instead of looking at the "crosswalk", look at the LCD/NCD for the cpt code.

search 70486 and click on the code.
on the top left under "medicare reference", click "local coverage determination" and then click your MAC (or if your MAC is not listed, click on another to see the info, if you want).
then click on the little "+" and it will expand the LCD and show you the billing and coding article.

I just did this and I see that the sinusitis codes are covered.

I hope this helps. and I hope you have access to the LCDs. I don't know the different levels of EncoderPro subscription include.
Thank you so much for your help!
 
Hello, I am new to ENT and am searching for free CEUs for ENT coding, including excisions and repairs for cancerous areas from head, neck, mouth, throat areas. Anything would be appreciated. Thank you,
Debbie
 
go to the MCD website
-there is a search box - next to it a dropdown menu to choose a specific state
- type in what you are searching for (cpt code, key words, etc) - in this case, I typed in 70486
- several billing and coding article/policies showed up in the results (for different MACs)

click on the results.

the site can be tricky, but I recomment playing around with it.
ALSO, check your MACs website. I know that Noridian has a great LCD page, that is super-easy to search.
 
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