ICD/CPT VNS removal Breast Cancer

Rip

Networker
Messages
53
Best answers
0
Any help would be appreciated.

Claim was denied by Medicare because not medically necessary.

Dx: 296.33
CPT 64570

Post Op Diagnosis: Remove Vagus Nerve Stimulator, non functional

Patient had VNS but did not help the deep depression.
VNS was "turned off" and no longer functioning.

Patient had Breast Cancer and needs followup imaging study.
Patient requested removal of VNS

Any hints on how to resubmit for payment?
 

mitchellde

True Blue
Messages
13,532
Location
Columbia, MO
Best answers
2
It is not medically indicated as your dx code is for a major depressive disorder. what was the reason for the surgery?
 

Rip

Networker
Messages
53
Best answers
0
Michelle,
The Dr. put
Post Op Diagnosis as: Vagus Nerve Stimulatar, nonfunctional
Coder put DX code of: 296.33 Major Depressive Disorder
CPT code 64570

I am a new (1month old) CPC-A trying to work through this denial.

The dr. indicated in op note that implanted VNS for severe drug resistant
depression and it was never helpful so it was turned off some time ago.
In the interim, she developed breast cancer and nees to have imaging study
to follow up for breast cancer. She requested to remove the nongunctional
VNS system.
 
Top