Wiki CPT 20611

[gitty1419@gmail.com]

Hi,

Does anyone know if Medicare has guidelines for CPT 20611?

I am trying to find a list of covered diagnosis since some payers that are following Medicare's guidelines are denying this code but I cant seem to find anything on the CMS website.

Any help would be appreciated!

 

[Orthocoderpgu]

Check the reason for the denial. I am seeing where they are denying this code for a copy of the ultrasound which must be on file.

 

[gitty1419@gmail.com]

A

Check the reason for the denial. I am seeing where they are denying this code for a copy of the ultrasound which must be on file.

As per the payer, they are only denying the claim because of the diagnosis.

 

[Orthocoderpgu]

So what diagnosis was submitted?

 

[OBCoderRobin]

I am in Indiana and Medicare here has an LCD for the 20611 - just an idea - you may want to check into that - plus I just worked a denial today and Aetna has a medical policy on these codes and this one is listed as Experimental and they do not cover it - regardless of the DX.