Wiki EMG diagnosis

[shanamarie]

Hello, looking for some help on a recent denial I have regarding diagnosis. If the indication for an EMG is numbness, and the impression states: Chronic appearing bilateral L5 and S1 radiculopathies, worse on the left. No evidence for active/ongoing denervation. Would this be enough to code the radiculopathy, or should the numbness just be coded?

 

[SharonCollachi]

If the impression is radiculopathy, which is what I am reading, why would you not think it was enough to code it?

Also, Parathesias, R20.2, is an accepted diagnosis for my Medicare payer.

 

[shanamarie]

If the impression is radiculopathy, which is what I am reading, why would you not think it was enough to code it?

Also, Parathesias, R20.2, is an accepted diagnosis for my Medicare payer.

Thanks for your response. We did code it as radiculopathy, but insurance took back payment saying the dx used is not supported by documentation. It has me completely confused because the radiculopathy is also on the LCD.

 

[SharonCollachi]

I would appeal, and point them to the paragraph in the report where is says radiculopathy, like this:

Perhaps you did not notice that on page 2, paragraph 3, 5th line, the physician states, "Chronic appearing bilateral L5 and S1 radiculopathies, worse on the left."

I tend to treat them like drunk idiots... take them by the hand and lead them to where I want them to go.