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Wiki Order of ICD 9

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cats2195

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I am new to anesthesia coding and have a question in regards to the order of the ICD 9 codes. We have had several claims denied for "not medically necessary". The claims included ICD 9 codes justify the procedure but not the need for supervised anesthesia. We are doing corrected claims but in what order do the ICD 9 codes need to be listed? ICD 9 justifying the procedure first or ICD 9 for the anesthesia?

Thanks for your help!!
 
The primary diagnosis should be the reason for the procedure. After that I would add any secondary diagnosis that help to support the need for a separate anesthesia provider.

Make sure to check with your Medicare carrier and/or other insurance providers for any LCD's/medical policies that pertain to the denial to see what codes support this need.
 
Would this apply to all Medicare. We are particularly having issues with Trailblazer, Texas Medicare?
 
I am assuming the denials are for Monitored Anesthesia Care. Yes, Trailblazer Medicare (who is the Part B carrier for Texas) does have a MAC policy. Not all Medicare Carriers have MAC policies in place.

Below is a link for their website. It brings you to the page to seach for LCDs. Just type in Monitored Anesthesia Care and it will bring you their LCD.

http://www.trailblazerhealth.com/Tools/LCDs.aspx?DomainID=1
 
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