Coding

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5
Location
Lafayette, TN
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0
Hello,

How do I code this case , a Medicare patient has a painful right ankle pressure ulcer , when billed to Medicare denied for not necessity , help please ,
"These are non-covered services because this is not deemed a 'medical necessity' by the payer

Cpt 11423 and 12042
DX L98499
 

ntreber

Networker
Messages
68
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my 1st guess would be an issue with the diagnosis code.
L98.499 = Non-pressure chronic ulcer of skin of other sites with unspecified severity
In your statement above you state that it is a Pressure Ulcer and L98.499 is for a NON - Pressure ulcer.
 
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