Wiki ICD-9 290.9 denial

[RebeccaWoodward*]

Medicaid has denied ICD-9 code 290.9 on a 47 yr. old male. Denial states diagnosis and age are not compatible. I've reviewed the ICD-9 book and it clearly indicates "A"...which equals=Adult Age (15-124). I've confirmed his true DOB and this does match what is indicated on his Medicaid card. I've requested the record but I don't see anything right off the bat...any thoughts?

 

[LLovett]

The only thing jumping out at me is the code first note under 290. Do you have a neurological condition to code first?

Laura, CPC

 

[RebeccaWoodward*]

Ahhh...I bet that's it. Maybe I need to replace my contacts...I declare...I did not see that the first, second, third time around...Time to break out the highlighters. Thanks!

 

[pamtienter]

Since the denial reason specified incorrect age, you might also check with the payer. Sometime they set up their own criteria and might have their own definition of the age group for "senile".

 

[RebeccaWoodward*]

I'm currently on their site and I thought Medicare was hard to navigate...O...M...G...I'll never complain again.............