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Wiki magnacare and knee xrays

Thread starter NEOSM507
Start date Apr 3, 2017

Create Wiki

NEOSM507

Guest

Apr 3, 2017

We have recently had some denials from Magnacare for CPT/DX mismatch. Here are 2 claims that denied:

73564/S83.8x1A- sprain of other specified parts of right knee

and

73562/S83.242A- other tear of medial meniscus,current injury, left knee

Both xrays had appropriate RT/LT modifier.

I cant find anything online on their xray coding policy. My thoughts are maybe they dont like "other" diagnosis codes??

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