MOHS 17311 etc Denials from United/CMS Guideline

LBernat7

Guest
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65
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Wayne, PA
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We have been receiving denials only from united healthcare that states the diagnosis or procedures don't meet medicare guidelines. However the diagnosis and procedures are correct and no other payers have this issue. We called and spoke to United and they just state the the diagnosis and procure don't match medicare guidelines. Anyone else have this issue
 

CodingKing

True Blue
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3,955
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What diagnosis? Is it listed as covered dx in an LCD/NCD? Was it unspecified code? If so Also is the date of service before or after 10/1/16?
 

robynreynon

Networker
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25
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What diagnosis? Is it listed as covered dx in an LCD/NCD? Was it unspecified code? If so Also is the date of service before or after 10/1/16?

Exactly what CodingKing said.. not enough information in this post to determine the cause. We bill Mohs to United multiple times a day and have not had issues, I would be curious to know what the diagnosis is you are using.
 
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