Wiki 82728

[ammontagano]

New to labs and need some info...pt had tests 84439, 84443, and 82728. Insurance is denying 82728 as inclusive, dx billed with 82728 was 729.5 Any thoughts?

 

[tanyaharberts]

I don't know why it would be inclusive, but that dx (729.5 - Pain in Limb) is not on the list for covered codes from CMS (http://www.cms.hhs.gov/CoverageGenInfo/downloads/manual200910.pdf#7).

However, 719.40-719.49 (Pain in joint) is on the list. Is there documentation to support this?

I don't know if the dx change will make a difference though if it's being denied as inclusive (not due to non-covered dx). ??