wandasw
Guest
I've just started doing coding for Nephrology and I have a new denial.
Patient presented to office with 4+ edema. Physician ordered IV infusion of Lasix 300 mg.
This was done as a two hour infusion, Not IV push.
Codes as
96363 x 1 unit DX 782.3, 585.3, 581.1
96366 x 1 unit
J1940 x 15 units
Medicare denied the infusion codes for CO-50 medical necessity and the Lasix as CO-151 meaning the number of units exceed allowed.
I couldn't get much info from CS at Medicare, but the only thing I can see is that maybe I should remove all the DX except the edema?? As far as the units, I can't get any answer as to the units issue with the Lasix.
Anybody have any idea what the problem is and what I need to do to correct?
Thank you,
Wanda Wages
Patient presented to office with 4+ edema. Physician ordered IV infusion of Lasix 300 mg.
This was done as a two hour infusion, Not IV push.
Codes as
96363 x 1 unit DX 782.3, 585.3, 581.1
96366 x 1 unit
J1940 x 15 units
Medicare denied the infusion codes for CO-50 medical necessity and the Lasix as CO-151 meaning the number of units exceed allowed.
I couldn't get much info from CS at Medicare, but the only thing I can see is that maybe I should remove all the DX except the edema?? As far as the units, I can't get any answer as to the units issue with the Lasix.
Anybody have any idea what the problem is and what I need to do to correct?
Thank you,
Wanda Wages