Wiki Medicare denials

[leren44]

Is anyone else getting Medicare denials for non-covered service when considered routine? Our office billed for 92014,92083,92250 with diagnosis codes H40.1233 (low tension glaucoma, severe) and H35.373 (puckering of macula).
Based on the diagnosis, this was not a routine visit. I have yet to contact Medicare. I was just curious if anyone else is having this issue?

Thanks for any input.

 

[briansmith99]

92014 is vision and I am used to seeing medicare refuse to pay for services billed with that code. Regardless of the attached dx medicare seems to view anything with the 92014 as routine vision.

 

[leren44]

Briansmith99, thanks for your input. According to cpt 92014 is for an established vision visit with initiation or continuation of diagnostic and treatment program so dx should not matter. Since we are an Ophthalmology office this would be the correct code for an established visit. We have not had any issues until icd10.