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ICD-9 290.9 denial

  1. #1
    North Carolina
    Question ICD-9 290.9 denial
    Medical Coding Books
    Medicaid has denied ICD-9 code 290.9 on a 47 yr. old male. Denial states diagnosis and age are not compatible. I've reviewed the ICD-9 book and it clearly indicates "A"...which equals=Adult Age (15-124). I've confirmed his true DOB and this does match what is indicated on his Medicaid card. I've requested the record but I don't see anything right off the bat...any thoughts?

  2. #2
    The only thing jumping out at me is the code first note under 290. Do you have a neurological condition to code first?

    Laura, CPC

  3. #3
    North Carolina
    Ahhh...I bet that's it. Maybe I need to replace my contacts...I declare...I did not see that the first, second, third time around...Time to break out the highlighters. Thanks!

  4. #4
    Since the denial reason specified incorrect age, you might also check with the payer. Sometime they set up their own criteria and might have their own definition of the age group for "senile".
    Pam Tienter, CPC, COC, CPC-P, CCS-P, CPMA, CPC-I, AAPC Fellow
    National Advisory Board Member 2018-2021, Region 6 Great Lakes
    Minneapolis AAPC Chapter, Education Officer 2018
    AHIMA ICD-10-CM/PCS Trainer
    AAPC National ICD-10 Trainer

  5. #5
    North Carolina
    I'm currently on their site and I thought Medicare was hard to navigate...O...M...G...I'll never complain again.............

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