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I received a denial from Medicare on an OV 99202, 20553 & J3301 - Medicare denied the 20553 with a reason code these are non covered services because this is not deemed a "medically necessity". DX 733.6 does any one understand this?
According to the Bulletin LCD #27540 Trigger Point Injections from the Novitas Web site,(Medicare) the following diagnosis are approved for Medical Necessity. If the documentation is there you can use one of the following- 7231., 7239., 724.1, 724.2, 726.19, 729.1. This information is from www. novitas-solutions.com/policy, just find your jurisdiction. I'm not sure if this helps you, depending on where you are from, the diagnosis could be different.
According to the Bulletin LCD #27540 Trigger Point Injections from the Novitas Web site,(Medicare) the following diagnosis are approved for Medical Necessity. If the documentation is there you can use one of the following- 7231., 7239., 724.1, 724.2, 726.19, 729.1. This information is from www. novitas-solutions.com/policy, just find your jurisdiction. I'm not sure if this helps you, depending on where you are from, the diagnosis could be different.