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Wiki Placenta biopsy

kimezell

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Has anyone else had problems with molina denying claims for diagnosis on a placenta biopsy? I could use a little guidance here. I hope someone can help. We received a di/di placenta delivered by c-section for biopsy with a 88307 cpt code and a diagnosis of dystrophic microcalcifications. We billed it with a diagnosis of 656.71, 654.21, and v91.03. They have denied it for incorrect procedure code/diagnosis. Can someone help before i have no hair left. I would be grateful for any input.
 
Did you charge for 88307 X 1 or X 2? You can use X 2 if each placenta was identified separately - such as "umbilical clamp on placenta A" or something similar.

If you are using V91.03 (for di/di), you need to use 651.01 (multiple pregnancy, twins) first.

I don't deal with that insurance provider, but if I were coding this, I would code:
656.71
651.01
V91.03

I hope that helps. :)
 
I should add that to charge 88307 X 2, each placenta needs to be identified AND reported separately.
 
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