Most MAC LCDs should include the following dxs:
| R22.31 | Localized swelling, mass and lump, right upper limb |
| R22.32 | Localized swelling, mass and lump, left upper limb |
| R22.33 | Localized swelling, mass and lump, upper limb, bilateral |
| R22.41 | Localized swelling, mass and lump, right lower limb |
| R22.42 | Localized swelling, mass and lump, left lower limb |
| R22.43 | Localized swelling, mass and lump, lower limb, bilateral |
| R60.0 | Localized edema |
| R60.1 | Generalized edema |
| R60.9 | Edema, unspecified |
| R06.02 | Shortness of breath |
| R07.1 | Chest pain on breathing |
| R07.81 | Pleurodynia |
| R07.82 | Intercostal pain |
| R07.89 | Other chest pain |
| R07.9 | Chest pain, unspecified |
For purely diagnostic purposes, I don't see any guidelines on primary diagnosis reporting for generalized Extremity Venous Evaluations (93970 and 93971), or anything else that might be causing a denial. You should consider the following guidance, however:
Pre-surgical Conduit Mapping for Coronary Artery Bypass Graft Procedures (93930, 93931, 93970, and 93971)
List ICD-10 code Z01.810 (Encounter for preprocedural cardiovascular examination) or Z01.818 (Encounter for other preprocedural examination) as the primary diagnosis. The secondary diagnoses should identify the reason for the study and/or findings.
Pre-surgical Vein-Mapping for Peripheral Arterial Bypass (93970 and 93971)
List ICD-10 code Z01.818 (Encounter for other preprocedural examination) as the primary diagnosis. The secondary diagnoses should identify the reason for the study and/or findings.
Vein Mapping for Dialysis Access (93970, 93971, 93985, 93986)
List ICD-10 code Z01.818 (Encounter for other preprocedural examination) as the primary diagnosis. The secondary diagnoses should identify the reason for the study and/or findings.
