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Order of ICD 9

  1. Default Order of ICD 9
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    I am new to anesthesia coding and have a question in regards to the order of the ICD 9 codes. We have had several claims denied for "not medically necessary". The claims included ICD 9 codes justify the procedure but not the need for supervised anesthesia. We are doing corrected claims but in what order do the ICD 9 codes need to be listed? ICD 9 justifying the procedure first or ICD 9 for the anesthesia?

    Thanks for your help!!

  2. #2
    The primary diagnosis should be the reason for the procedure. After that I would add any secondary diagnosis that help to support the need for a separate anesthesia provider.

    Make sure to check with your Medicare carrier and/or other insurance providers for any LCD's/medical policies that pertain to the denial to see what codes support this need.
    Missy Heuer CPC, CIRCC, CANPC

  3. Default
    Would this apply to all Medicare. We are particularly having issues with Trailblazer, Texas Medicare?

  4. #4
    I am assuming the denials are for Monitored Anesthesia Care. Yes, Trailblazer Medicare (who is the Part B carrier for Texas) does have a MAC policy. Not all Medicare Carriers have MAC policies in place.

    Below is a link for their website. It brings you to the page to seach for LCDs. Just type in Monitored Anesthesia Care and it will bring you their LCD.
    Missy Heuer CPC, CIRCC, CANPC

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