Wiki Venous Doppler Leg study payable diagnoses

[laceyb1116]

What signs/symptoms are most payable for these studies... leg pain, edema, swelling, redness, shortness of breath - are these requiring more than one diagnoses in the new year? Or group has been outsourced so I am not as current on this topic as I usually would be. Any help is greatly appreciated!

 

[BrettAAPC]

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.