Wiki Osteopathic Manipulation Denials

[jmeberst314@gmail.com]

My OMT claims have been denying with reason "number of spinal/body regions within dx submitted does not correlate to the number of regions described in the procedure". My question is directed towards 98927-98929 specifically, between these codes there are 5-10 regions that can be treated. And in order to correlate the diagnosis (739.0-739.9) you would need a dx for each region, but if 7 regions were treated how do you code all seven dx's with only four dx's lines available for assignment?

 

[maryc@trgltd.com]

manipulations - OMT

Unfortunately, I believe you'll have to go to multiple pages -- which may mean hard copy claim submission. You may also want to consider pre-authorizing the service with your regional dx.

I double checked back through 1997 in the Pink Sheets to see if there was anything here that could help you.....nada.

Again, I think pre-auth specifics would help.

Good luck,
Mary

 

[jmeberst314@gmail.com]

Mary,
Thank you for responding, I will have to look into the preauthorization as the manipulations generally aren't the reason for the visits so it would be kind of hard to get them pre-authorized. I guess for now I'll have to just assign the codes and do multiple page claims and if that doesn't work submit copies of the medical records. Thanks again!

Jessica

 

[mitchellde]

My OMT claims have been denying with reason "number of spinal/body regions within dx submitted does not correlate to the number of regions described in the procedure". My question is directed towards 98927-98929 specifically, between these codes there are 5-10 regions that can be treated. And in order to correlate the diagnosis (739.0-739.9) you would need a dx for each region, but if 7 regions were treated how do you code all seven dx's with only four dx's lines available for assignment?

The 5010 electronic transaction gives you 12 dx codes spots to use.