Wiki Dx code for 92511

[eminey]

Had a claim come back with denial of 92511 for incorrect diagnosis linkage. They linked it to H69.91 (ET dysfunction); J30.89 (allergic rhinitis), Q67.4 (congenital abnormality....) I thought ET dysfunction would be adequate to justify for the scope. Apparently not. Pt had nasal congestion so I was wondering if that would work. Thanks.

 

[b.cobuzzi]

I would appeal the denial. Point out in the appeal that the Eustachian tubes terminate in the nasopharynx and that is what the nasopaharogoscopy was looking at the terminus of the Eustachian tubes. You need to give an anatomy lesson to the payer.


Barbara J. Cobuzzi MBA, CPC, COC, CPC-P CPC-I CPCO, CENTC
Consulting Editor Otolaryngology Coding Alert
www.CRNHealthcare.com
b.cobuzzi@att.net