Question TRIWEST/Humana Military Referral and pain management help

amowens854

Contributor
Messages
11
Location
Newport, NC
Best answers
0
I was wondering if when a patient has a referral from TRIWEST or from Humana military and they give the accepted Dx or reason for the referral does that mean it has to be the first listed Dx to be paid? I work in Pain management and with Chapter 6 guidelines a patient is being seen for pain management/pain control you are supposed to code G89 then the underlying reason for the pain, if known. What i'm asking is if the "accepted Dx" isn't first and G89 is first then will the insurance pay? Any insight would be greatly appreciated!!
Thanks!!
 
Messages
4
Best answers
0
You should have received a pre-appointing letter from TriWest that includes a range of covered CPT and ICD10 codes. The codes should be listed under the "standard episode of care" information on the letter.
Hope this helps!
-Kristina
 
Top