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Wiki 92941 denial

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karbaker

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Our local HMO is denying 92941 for PQRS, stating patient does not fall into the age criteria of 18 to 75, our patient is 80, I am thinking we may have a DX error, we coded 410.41, 786.59, 401.1. What are your thoughts, any input will be helpful, thanks in advance

karen
 
Your dx and procedure coding coding looks correct to me. I would verify how your claim went over to them. Something may have gotten mixed up in the transmission and some numbers may have been transposed?
 
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