Wiki First Coast Medicare?

[punkyboo]

Hello,

So, we are in FL, the ones with the oddball Medicare carrier who did not used to want a subluxation code as a primary dx on their claims. Now suddenly I got a bunch of C0-50 denials, looked and saw that there is a new LCD for 98940, 98941, etc (effective 9/12/16)...has anyone else in FL experienced this, and does it look like First Coast is now going to start wanting M99.01-M99.05 as primary dx?

Thanks for any help anyone can offer!

Kat

 

[tinafay78]

I'm in AZ but bill for providers in other states also. The primary DX code should always be a M99.__ for MC or any MC Advantage plans.
I have not had a denial using sublux, degen, sublux, sublux

Hope it helps

 

[kleger]

We changed our coding as of 9/12/16 to use the sublux codes as primary and haven't had a problem with denials (knock on wood).

 

[punkyboo]

Thanks for your responses!

I have been adding the M99__ sublux codes on (primary of course), and I too have not had a denial on those yet.

I really do appreciate the input!!!

-Kat in FL