anknight77
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We had a patient present today that was referred to us by their ophthalmologist due to retinal pigmentation. This could represent familial polyposis syndrome, but without further testing (colonoscopy, EGD, abdominal ultrasound) this can't be diagnosed at 100% certainty. The patient hasn't had any genetic testing up to this point either. I don't believe I can get any of these procedures covered with the referral diagnosis of Q14.1 Congenital malformation of retina. Does anyone have any experience getting procedures paid in this instance?