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jessica_hall1

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Hello - I've just started coding for a pulmonary practice which is a new specialty to me, and I'm having some trouble with coding for multiple pulmonary nodules. The providers and the other coder in the office have been using R91.8, but now I've been told that diagnosis code has been getting denied by payers. I would appreciate any insight into this, as this is something we see quite a bit with our patients. Thank you!
 
R91.8 is the correct code assignment for 'multiple pulmonary nodules' if there is no definite diagnosis made yet.

For what reason are your payers denying this and what types of services are being denied?
 
thomas7331 said:
R91.8 is the correct code assignment for 'multiple pulmonary nodules' if there is no definite diagnosis made yet.

For what reason are your payers denying this and what types of services are being denied?
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Thanks so much for responding, I'm not sure exactly what the detail of the denials are I just received an email saying not to use R91.8 anymore. I'm going to speak with the biller when I'm back in the office on Tuesday, but wanted to research a bit on my own first before talking with her.
 
jessica_hall1 said:
Thanks so much for responding, I'm not sure exactly what the detail of the denials are I just received an email saying not to use R91.8 anymore. I'm going to speak with the biller when I'm back in the office on Tuesday, but wanted to research a bit on my own first before talking with her.
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It's not the billers place to say what codes to use or not use, as I'm sure you're aware. Codes are assigned based on documentation, not on whether or not the payer will deny.
 
thomas7331 said:
It's not the billers place to say what codes to use or not use, as I'm sure you're aware. Codes are assigned based on documentation, not on whether or not the payer will deny.
Click to expand...
Exactly, which is why I was confused as to why the other coder was just following suit on this. But since I am new to the specialty, and this office I wanted to make sure I had all of my ducks in a row before I spoke up next week. Thanks again for your insight.
 
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