Wiki Excludes 2 for H16.011 and H16.223

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tlwhlw

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We have several DOS's denied for MA63 Missing/Invalid Principal Diagnosis. The CPT is 92012 w/DX H16.001 and H16.223. After reviewing the chart notes, there is also B20 (HIV) listed in the DX list. ICD-10-CM has a note to use an external cause code for the eye condition....and is also indicating an excludes 2 for these DX codes. Can someone please clarify what this means? Do we need to include the B20 DX code? Thank you for your help!

I am new to the ophthalmology coding world, so any help is appreciated. If there is a good eye website to use, please let me know.
 
Hello there,
I have looked at these two dx and I don't see why you should be getting denied.
I have worked in ophthalmology for many years. I have been using these dx's frequently. I have not
see any problems.
I would suggest calling on a couple and make sure that the dx's went over as you have them entered.
 
Thank you for your answer....everything going through correctly, so will have someone else in our auditing department look into this further. :)
 
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