Results 1 to 7 of 7

Medicare Denials 92014

  1. #1
    Default Medicare Denials 92014
    Medical Coding Books
    I am doing follow up for a large Hospital Clinic and all of their eye exams are being denied CO-50 (92014). They are being billed for cataracts and other medical conditions, not routine. Does anyone know the policy?

    Thank you!

  2. Default
    92014 is a routine code and Medicare will not pay it. They should be billed as office visits using 992xx codes as appropriate based on new/established patient and level of care.


  3. #3
    Medicare Part B will pay on 92014 with a medical diagnosis. I work for an optometry practice and have worked for an ophthalmology practice and have billed this way successfully in both.

    That being said, many secondary insurances require a 99xxx code with a medical diagnosis, and if that is the case, I will make sure to bill with a 99xxx code.

    You say you work for a "hospital clinic" - are your patients inpatient or outpatient?

  4. #4
    All outpatient. So what would a possible reason be for denying with a CO 50? There is no NCD or local LCD. Any thoughts? (like I said all have a medical dx)

  5. #5
    Columbia, MO
    Is that the only charge on the claim? is this the first visit to diagnose the cataracts, has surgery been scheduled?

    Debra A. Mitchell, MSPH, CPC-H

  6. #6
    Sometimes surgery has been scheduled, sometime no record of surgery or there is other medical dx such as vitreous occlusion. All are denied CO50

  7. Default
    Are these all Medicare denials? They should pay for 92014. Actually, they do. Also, the code has utilization parameters. If the patient has had too many of these comprehensive visits within the same year, that may be causing denials.
    I would call and find out. Maybe there's a problem somewhere else.

Similar Threads

  1. Medicare denials
    By leren44 in forum ICD-10
    Replies: 2
    Last Post: 10-14-2015, 09:59 AM
  2. Medicare denials-If a service is
    By nc_coder in forum Medicare Regulations
    Replies: 5
    Last Post: 04-10-2013, 02:45 AM
  3. Medicare denials
    By Thouvenel in forum Medicare Regulations
    Replies: 2
    Last Post: 05-25-2012, 09:42 AM
  4. medicare denials
    By eferris in forum Orthopaedics
    Replies: 1
    Last Post: 03-16-2010, 09:16 AM
  5. Medicare Denials
    By msmurdaugh in forum Dermatology
    Replies: 5
    Last Post: 11-19-2009, 08:55 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.