Wiki Podiatry Billing question

[catthmps2]

Hello, I am a Podiatry biller. The procedure code used is 11720 and the DX code used is E11.42 . This is the procedure and DX code I've used in the past. But for some reason Medicare is rejecting stating not a medical necessity. I need to know what DX code or Modifier needs to be used to get this paid. Can someone please assist me?
Thanks

 

[cathya35]

Look at Medicare LCDs in your area

I would appeal the denial as this should be a covered procedure for this diagnosis code. More information here: https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/bp102c15.pdf