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Wiki Unspecified codes

calexander1265

Networker
Messages
50
Location
Mint Hill, NC
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I am having a debate with some staff regarding the appropriateness of billing unspecified codes. While I'm aware Medicare and other insurances no longer reimburse for unspecified codes, my understanding is there are certain unspecified codes which will be covered, and these codes are in the listing on CMS web site for ICD-10 codes 2017.

For example, J32.9 Chronic sinusitis, unspecified. If the provider doesn't know which sinus cavity is impacted, how can he code anything else. Or H40.003 - Preglaucoma, unspecified, bilateral, would this be payable by Medicare?

Just need some clarification.

Thank you
 
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