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v76.51 denials

  1. #1
    Default v76.51 denials
    Medical Coding Books
    We are getting denials for 82272 with V76.51. Is there another screening code anyone is using that they are getting paid on. V76.51 is no longered listed on NCD as a payable DX for this procedure. All suggestions are appreciated.

    Thanks

  2. #2
    Default
    I believe 82272 is to be used if the patient is having symptoms. Try 82270 and see if V76.51 is listed as an acceptable dx for that. Hope this helps!
    Susie Corrado, CPC
    __________________
    ENT Coding/Billing

  3. #3
    Default
    Yes I looked at 82270 with V76.51 is not listed as a covered Dx.

    Thanks for your help

  4. #4
    Location
    Dover Seacoast New Hampshire
    Posts
    1,970
    Default
    The problem isn't with your diagnosis code, it's with your CPT code.

    Per the January 2011 NCD report, 82272 is "performed for other than colorectal neoiplasm screening". Essentially, to bill that code, patient should have a symptom. Use 82270 FOBT or G0328 (read the code descriptions) for screening. The Medicare preventive services guide recommends you contact your local carrier for the appropriate diagnosis code for 82270.
    Pam Brooks, MHA, COC, PCS, CPC, AAPC Fellow
    Coding Manager
    Wentworth-Douglass Hospital
    Dover, NH 03820

    If you can dream it, you can do it. Walt Disney

  5. #5
    Default
    Thanks Pam

    So does the location matter? I thought that 82272 was in offfice and 82270 was when the patient took cards home and return them to the office?

  6. #6
    Location
    Dover Seacoast New Hampshire
    Posts
    1,970
    Default
    The patient can take them home, but you shouldn't bill them till they are resulted in the office. POS will always be office, anyway, because that's where they're resulted.

    The qualifier for the code isn't the place of service, it's screening vs. diagnostic.
    Pam Brooks, MHA, COC, PCS, CPC, AAPC Fellow
    Coding Manager
    Wentworth-Douglass Hospital
    Dover, NH 03820

    If you can dream it, you can do it. Walt Disney

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