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618.9 denied for age??

  1. Default 618.9 denied for age??
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    Hello, i was just asked to find out information why ICD9 618.9 would be denied for members age. I have been looking and cant find anything with age regulations.
    any help or ideas would be great

  2. #2
    Default 618.9
    Hello: 618.9, unspecified genital prolapse would tend to be more in older patients, I would assume.

    If you could get your Dr. to state more clearly a more specific type of prolapse
    (618.81, 618.82, 618.83, 618.84 or 618.89) you may have a better chance of getting paid.

  3. Default 618.9
    Thank you. Thats what i was thinking as well, however having something in writting would help get that inforced and I cant find a single LCD or billing guideline regarding an age limit/restriction.. have you been able to find anything?

  4. #4
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    Quote Originally Posted by DYslas View Post
    Hello, i was just asked to find out information why ICD9 618.9 would be denied for members age. I have been looking and cant find anything with age regulations.
    any help or ideas would be great
    My first question is, what age was on the claim for the patient? Sometimes errors occur on the claim. There are no age restrictions, unless the patient age on the claim was for a child. I have had claims where at some point in data entry a wrong number was entered that changed the age of a patient. Check that out first...then appeal the claim.
    Arlene J. Smith, CPC, CPMA, CEMC, COBGC

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