Wiki Total Joint post op x-ray dx

[aswearingen]

We are getting denials from one local FL payer for using Z96.6xx on total joint post op xray charges. Their denial is stating there is a more appropriate diagnosis code for the procedure billed. I am not sure how much more specific we can be when this is just an xray for a post op visit from total joint replacement case. Thoughts?

 

[thomas7331]

Your primary diagnosis should be Z47.1 - Aftercare following joint replacement surgery - followed by the Z96.6- code. The Z96.6- codes only indicate a status and do not stand alone to support medical necessity or indicate the reason for the services.