E/M Denials

dmccullers

Networker
Messages
43
Location
Thomasville, GA
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I have been seeing a lot of denials lately from Humana and BCBS stating "missing/incomplete/invalid other diagnosis". The codes that we are using are I83.813 Varicose veins of bilateral lower extremities with pain, I83.893 Varicose Veins of bl low extrm w other complications, R60.0 Localized Edema. I am not sure why these codes would not be covered. Does anyone else know?
 

Pam Brooks

True Blue
Local Chapter Officer
NAB Member
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2,167
Location
South Berwick, ME
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1
I'm taking a stab here but Varicose veins with pain and edema would be reported with I83.813 and I83.893. You wouldn't also code the edema becasue the I83.893 includes edema. I believe that's the code you're missing.
 
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