Wiki Facet Denials Please help

[bella2]

Hi, I code for an ASC and we are seeing tons of denials from Medicare for medical necessity but the Dx provided is on their LCD list, I heard that quite a few people are seeing denials based on the time frames and dates when these injections are given. I would really love to here feedback and if anyone has information about the times or dates between when these injections are perfomed it would be great to her from you.

Thanks in advance for all responses.
Cheers,
Bella

 

[HReed]

I was working for an ASC and we didn't have problems with denials. I'm in Arizona and I did need to make sure the modifiers were correct. If they weren't, a denial for medical necessity would occur regardless of the diagnosis. I would look at the modifiers first to troubleshoot the claim.

 

[coderguy1939]

Can you give an example of what procedure codes you're submitting and the DX codes?

 

[elenax]

I'm having the same problem too...I would like to hear some feedback on this as well!