Wiki claim denied medical necessity

[Stevejost23@gmail.com]

Patient had an ultrasound (76881) possible hernia. Icd 10 code being denied due to medicare's LCD. None of the ones on the list seem to match. Any thoughts?

 

[SharonCollachi]

Did anyone check for LCD before doing the procedure? If it is not indicated for the diagnosis, and you did not get a fully completed ABN, then you'll be writing it off.

 

[csperoni]

Are you sure you're using the right ultrasound code? Isn't 76881 for an examination of a joint, which may be why none of the covered diagnoses match.

 

[TPeniston61]

I think you need 76882. 76881 addresses the joints. 76882 address soft tissue structures.