HI! I am having trouble getting pass the Medicare CCI edits for CPT 20611. My doctor did a corticosteroid injection to help treat Piriformis Syndrome. The CCI edit that I am running into is as follows:
[Medicare] Per Medicare's Local Coverage Determination (LCD) policies, procedure code 20611 is not considered to be medically necessary when supported by the diagnosis code G5701. Please review the medical record and procedure and diagnosis coding on the Claim Edit screen.
I cannot locate a diagnosis that will remove the CCI from my claim so it will drop. Below are a list of ICD-10 codes I have tried and have been unsuccessful with:
1. M4806 SPINAL STENOSIS, LUMBAR REGION
2. G5701 LESION OF SCIATIC NERVE, RIGHT LOWER LIMB
3. M5417 RADICULOPATHY, LUMBOSACRAL REGION
Please let me know if you have had this issue or have any advice for me.
Thanks!
[Medicare] Per Medicare's Local Coverage Determination (LCD) policies, procedure code 20611 is not considered to be medically necessary when supported by the diagnosis code G5701. Please review the medical record and procedure and diagnosis coding on the Claim Edit screen.
I cannot locate a diagnosis that will remove the CCI from my claim so it will drop. Below are a list of ICD-10 codes I have tried and have been unsuccessful with:
1. M4806 SPINAL STENOSIS, LUMBAR REGION
2. G5701 LESION OF SCIATIC NERVE, RIGHT LOWER LIMB
3. M5417 RADICULOPATHY, LUMBOSACRAL REGION
Please let me know if you have had this issue or have any advice for me.
Thanks!