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Medicare patient presented for med-refill. The patient was previously prescribed furosemide (Lasix) due to bilateral swelling in her lower extremities from travel. The patient has a history of swelling during travel. The swelling in question persisted for 5 days and the patient was prescribed (by an out-of-state physician) the diuretic to eliminate the swelling. The patient requested a refill for the temporary supply.
Question is: The provider billed a Dx of Z87.898 "Personal history of other specified conditions" with CPT 99213 for the visit. Medicare obviously denied given the diagnosis code. The specific code said it was due to the exam being a "non-covered service because it is a routine/preventive exam or a diagnostic/screening procedure done in conjunction with a routine/preventive exam."
Would you A) Rebill with a more appropriate diagnosis (I was thinking R60.0 "localized edema") or B) Something else.
Question is: The provider billed a Dx of Z87.898 "Personal history of other specified conditions" with CPT 99213 for the visit. Medicare obviously denied given the diagnosis code. The specific code said it was due to the exam being a "non-covered service because it is a routine/preventive exam or a diagnostic/screening procedure done in conjunction with a routine/preventive exam."
Would you A) Rebill with a more appropriate diagnosis (I was thinking R60.0 "localized edema") or B) Something else.