Wiki Total Joint revision CMS LCD L33456

[KMCFADYEN]

Is anyone currently having any issues with CMS LCD L33456 for total joint arthroplasty?

I am having some issues with the revisions denying for the LCD/not medically necessary when we have used a diagnosis listed in the LCD (and documented in the op note, of course).

 

[adown999]

Total Joint CMS LCD L33456

I am having issues with claims denying too! I was looking out here to see if there are any suggestions.

 

[KMCFADYEN]

I am having the same issues.
I have been sending a redetermination with the op notes and the LCD stating that we used the correct diagnosis but have not have received any payments yet.

 

[KMCFADYEN]

I have just found out that there needs to be a secondary diagnosis on the revisions.