• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki Billing two M54.1- codes together

VMaes

New
Messages
1
Best answers
0
I have a few denials with both M54.15 and M54.16 on the same claim. I am seeing these could possibly be exclusionary and I am hoping to verify this and find out why?
 
M54.16 is redundant. You've already told them the patient has pain somewhere in the lumbar region because M54.15 says the problem is in the thoracic and lumbar areas. That could be anything from T1 to L1 or T12 to L5. As long as you have one T and one L, or the provider says it's in the thoracolumbar region, you only need the one code.
 
Top