Hi, so I am getting increasingly frustrated with Zelis coding denials. I keep getting "Procedure not compatible with diagnosis" denials. For example with closure gastrostomy surgery 43870, we are getting a denial for dx code K31.6 (fistula of stomach & duodenum). I have been using these codes together for years. I checked the coding software I use & K31.6 is the number 1 code listed under 43870. Whenever I call Zelis they provide zero help. Does anyone have a document that shows the dx codes that they don't like in relation to specific CPT codes? Or does anyone know how I can get these denials paid and have had luck?
Thank you in advance- rant ended haha
Jessie W, CPC
Thank you in advance- rant ended haha
Jessie W, CPC