I had previously posted a query in which I did receive an answer. My problem is that we are receiving a medicare denial for not medically necessary.
Physician excised 2 separate lesions, one on the scalp and other on the leg smaller than 1cm, pathology for both reported as hemangioma. I coded DX as 228.01.
Looking at LCD for Az ,228.01 is not a diagnosis showing medical necessity.
Called the physician and they stated they never wait for the path report and they coded as 216.4 and V49.89, and they were paid.
Please help, as I have always been told to code dx off path report.
Paula
Physician excised 2 separate lesions, one on the scalp and other on the leg smaller than 1cm, pathology for both reported as hemangioma. I coded DX as 228.01.
Looking at LCD for Az ,228.01 is not a diagnosis showing medical necessity.
Called the physician and they stated they never wait for the path report and they coded as 216.4 and V49.89, and they were paid.
Please help, as I have always been told to code dx off path report.
Paula