Wiki G56.03 and M54.16 Claim Denials

[celcano]

Good afternoon, all. I have an insurance carrier who is denying claims when ICD-10 codes G56.03 (carpel tunnel syndrome, bilateral, upper limbs) and M54.16 (Radiculopathy, lumbar region) are billed together. The denial states that these two codes cannot be billed together "based on the Excludes 1 Notes instructions in the ICD-10-CM Official Guidelines for Coding an Reporting {see Excludes 1 Notes under heading "Nerve, nerve root and plexus disorders (G50-G59}." This does not make any sense to me as these are two different of the body. I would understand if these were 2 lumbar diagnoses. Can someone help put this in perspective for me or how I can fight this denial?
THANK YOU for your assistance.

 

[kdlberg]

Because clinically, cervical radiculopathy can cause carpal tunnel syndrome. The nerves at C6-C8 also feed the median nerve, so if you have a pinch at the top, it can cause problems further down the line. Can they be unrelated and co-occur? Yes. Are you going to be successful in appealing an excludes1? I really don't know.