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95018 MMO denials

J

jazzyblues2005

Networker
Messages
53
Location
Lima, OH
Is anyone else having trouble with MMO denying 95018 with dx 477.8. According to their policy a secondary dx is required for medical necessity. The secondary dx is a 995.xx code and only 4 of those are approved. Our issue is that not every patient has a problem that calls for one of those codes, but MMO won't pay without it.

Has anyone else run into this?
 
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