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Wiki Neoplasm Specificity

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melheffley

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Caledonia, OH
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We recently had a claim deny from our local Medicare stating that we need to "code to the highest level of specificity". This was for a 2009 office consult (99245) with our Oncologist. We used DX 174.4 which is valid for 2009. In the CPT book we see where is states that V86.0 & V86.1 are used as secondary. We have never ran into this problem before. Was there a policy change or update, that we missed? We have searched everything we can think of, and turned up nothing. Has anyone else ran into this or seen any information on it? We are located in Ohio. Thanks in advance!
 
Very interesting

It does state in ICD-9 that you need to code those V codes 2ndary, I did not know that either. I guess I am guilty of not going back to the tabular section of the book on dx from the neoplasm table.

I am currently in Michigan and we have not had that problem, but I will be watching for it now.

Thanks

Laura, CPC
 
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