Wiki Denial from BCBS for dx code inconsistent with procedure code

[calumfan]

I work in a Neurology clinic with a physician who specializes in movement disorders. Yesterday we received 3 denials from Blue Cross with the Reason Code CO 11 attached, the diagnosis is inconsistent with the procedure.

I coded the visits as follows:

G20 (Parkinson's Disease) as the primary diagnosis code.

99214 (Office Visit Level)

I am puzzled as to how G20 would be a diagnosis inconsistent with an established office visit level 4. All 3 patients have a long detailed history of being seen for their Parkinson's. I'm not sure how I should proceed in re-coding these claims.

Any help in understanding this would be appreciated.

 

[mitchellde]

Perhaps they are thinking a level 4 is not supported by the G20 alone. Does the documentation support a level 4?