11900-59 coded 20553-59, main procedure 62311

evillan2015

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We billed CPT Code 62311, 20553-59, 11900-59, 99144 99145, 77003-59, 72275-59,J3301, J3010, J2250, all paid but 99144, 99145 these two denied because the claim was split and the main procedures 62311 was split from those procedures. They are going to resubmit. But the 11900-59 was denied per reason below.
DX
M16.11
M54.14
M79.1
M62.838

Aetna denied 11900-59 as This service does not meet the coverage requirements in the applicable Local Coverage Determination LCD or NCD. Related services performed in connection with the denied procedure are also not covered.. confusing because the 623112 & 20553-59 paid.

the procedure was submitted w/all the dX listed. Is this 11900 DX driven? The area injected was the hip -neuroma scar . Should this code gone through with only these DX
M16.11
L90.5 Scare conditions/Fibrosis of skin? or with all the above Dx codes?

or with the four DX above with th M16.11 as primary?

Please advise

Thank you in advance,

Elizabeth
 
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