Wiki Dx code 367.20 age specifications

[tgutierrez]

Hello fellow coders.

I work at an ASC and we do a lot of eye surgeries. I am in Arizona and one of my AHCCCS (Medicaid in other states) plans is denying procedures that I am billing dx code 367.20 with (not primary dx, it is listed as 2nd dx on claim) stating that the patient's age is inconsistent with dx. I called and they state there is an age range of 0-20 years old listed with this dx code. I'm completely confused.

I have not been able to find anything with age specifications for this dx code.

Can anybody help? Or direct me where I might find age specifications for this dx?

Thanks!

 

[kcope]

You are correct

I also looked it up and there are no age specifics at all. 367.20 is for a general Astigmatism, unspecified period. Good luck with that.

 

[mitchellde]

perhaps they only cover that diagnosis for that age range? That is the only thing that makes sense.