D22.5 and D22.39 coded togther on OV?


Wayne, PA
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We had some claims rejected by IBX (we are in PA) and when we called they said they were denied because the provider coded D22.5 (nevus on trunk) and D22.39 (nevus on face) both on the Office visit 99213. They said those codes cannot be used together. Dr states pt came in for DN on the trunk which he looked at but didn't bx and one on the cheek. same thing no bx done. Can I get some info on this as to why? thanks
There is no coding rule that says these cannot be used together - I think you have been given incorrect information by the payer representatives to whom you spoke. Payers generally do not employ certified coders to answer provider inquiries so it is very common to get this kind of misinformation from them. You'll need to push back on this to either get a better answer or get them to correct their error .