Wiki Denial of 22513 and 22514

HeidiJo

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I had been billing these codes with no issue. Now I have been getting it denied as "experimental or not medical necessary". One of the denials was from September (UHC) and one is from October (Medicare). Since they are not both after the Oct 1st deadline I am assuming that it can't be an ICD-10 "glitch". Any advice? Maybe some new changes that I missed?
 
Sounds like it is a medical policy.
Many insurances including many Medicare carriers have an LCD on this procedure.
Make sure that protocol was followed and you have the correct medically necessary diagnosis as that will get a denial.
 
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