I am having some trouble with Medicare paying 99406 or 99407 when billed with E/M code using Dx F17.210. The denial is for "not medically necessary" Any suggestions?
I appreciate any help
Maru
I spoke to Medicare on this and you need an add'l dx code. Primary code must be ones of these and then a secondary code.
Following ICD-10 codes for Nicotine use require additional dx for a disease or an adverse health effect linked to tobacco use, or for a patient who is taking a therapeutic agent whose metabolism or dosing is affected by tobacco use
F17.200 Nicotine dependence, unspecified, uncomplicated
F17.201 Nicotine dependence, unspecified, in remission
F17.210 Nicotine dependence, cigarettes, uncomplicated
F17.211 Nicotine dependence, cigarettes, in remission
F17.220 Nicotine dependence, chewing tobacco, uncomplicated
F17.221 Nicotine dependence, chewing tobacco, in remission
F17.290 Nicotine dependence, other tobacco product, uncomplicated
F17.291 Nicotine dependence, other tobacco product, in remission
T65.211A Toxic effect of chewing tobacco, accidental (unintentional), initial encounter
T65.212A Toxic effect of chewing tobacco, intentional self-harm, initial encounter
T65.213A Toxic effect of chewing tobacco, assault, initial encounter
T65.214A Toxic effect of chewing tobacco, undetermined, initial encounter
T65.221A Toxic effect of tobacco cigarettes, accidental (unintentional), initial encounter
T65.222A Toxic effect of tobacco cigarettes, intentional self-harm, initial encounter
T65.223A Toxic effect of tobacco cigarettes, assault, initial encounter
T65.224A Toxic effect of tobacco cigarettes, undetermined, initial encounter
T65.291A Toxic effect of other tobacco and nicotine, accidental (unintentional), initial encounter
T65.292A Toxic effect of other tobacco and nicotine, intentional self-harm, initial encounter
T65.293A Toxic effect of other tobacco and nicotine, assault, initial encounter
T65.294A Toxic effect of other tobacco and nicotine, undetermined, initial encounter
Z87.891 Personal history of nicotine dependence
