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Wiki Billing Medicare CPT 11055 - painful corns

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wilsontheresa@optonline.net

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Our derm is billing CPT 11055 to Medicare for painful corns on patient's right foot. Patient has SLE (systemic lupus erythematosus). I attempted to bill the pain code M79.674 as the first Dx, then M32.10 (SLE) as the second Dx and L84 (corns and collosities) as third Dx. This was denied as not medically necessary. Can anyone offer some guidance? thank you.
 
Your primary dx should be L84 and secondary dx should be M79.674. There is an LCD on this and there are not very many dx that support medical necessity.
 
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