Results 1 to 6 of 6

Bone Marrow Abnormality

  1. #1
    Location
    Seacoast-Dover NH
    Posts
    42
    Question Bone Marrow Abnormality
    Exam Training Packages
    I have pathology reports that have provided a final diagnosis of bone marrow abnormality/bone marrow clot after performing CPT 88342. I have tried using 796.4 as well as a couple of other diagnosis codes, but am hitting medical necessity edits. I have been given the task of finding an alternate ICD-9 code code that will not hit mn edits. Does anyone have any suggestions?

  2. #2
    Default
    Quote Originally Posted by Kdailey View Post
    I have pathology reports that have provided a final diagnosis of bone marrow abnormality/bone marrow clot after performing CPT 88342. I have tried using 796.4 as well as a couple of other diagnosis codes, but am hitting medical necessity edits. I have been given the task of finding an alternate ICD-9 code code that will not hit mn edits. Does anyone have any suggestions?
    Doesn't sound right for the path report to just say that, but I could be wrong. What was the reason for the biopsy?

  3. #3
    Location
    Seacoast-Dover NH
    Posts
    42
    Post
    The biopsy was for a bone marrow clot.

  4. Default denied
    Try looking up the local coverage determination for the procedure on the Medicare site. It should give a list of medically necessary diagnoses.Then submit that list to your provider and IF THE PATIENT HAS one of the medically necessary diagnoses- have him document that in the note.

  5. #5
    Default
    Quote Originally Posted by Kdailey View Post
    I have pathology reports that have provided a final diagnosis of bone marrow abnormality/bone marrow clot after performing CPT 88342. I have tried using 796.4 as well as a couple of other diagnosis codes, but am hitting medical necessity edits. I have been given the task of finding an alternate ICD-9 code code that will not hit mn edits. Does anyone have any suggestions?
    Did you try 289.89? You're definitely being denied due to a lack of specificity - that's a very specific test, so it's going to require a very specific diagnosis to match.

  6. #6
    Default
    I found a lot of coverage policies on them, but without knowing more about what payer it is, the results won't be of much help. Go to yahoo.com (not google - their results aren't as good for this...)

    In the search bar, paste this:
    medical necessity immunohistochemistry test

    And tack on the name of either the payer you're looking for (eg, UHC, Aetna, Blue)
    Or, for govt. payers, enter the name of your state (and for Medicare, add "LCD")

    Hit search, and it should pop up on one of the first couple of pages.

Similar Threads

  1. bone marrow aspiration/ bone biopsy
    By chembree in forum Interventional Radiology
    Replies: 1
    Last Post: 06-18-2014, 01:45 AM
  2. bone marrow aspiration for bone grafting
    By DebiMax in forum General Surgery
    Replies: 2
    Last Post: 09-30-2013, 07:20 PM
  3. Biopsy- bone or bone marrow ????cpt code
    By Barbs63 in forum Orthopaedics
    Replies: 0
    Last Post: 05-02-2013, 02:48 PM
  4. Bone Marrow BX
    By nlaaron in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 02-23-2012, 02:56 PM
  5. Bone marrow with NP
    By cpccoder2008 in forum Hematology/Oncology
    Replies: 2
    Last Post: 05-21-2010, 06:16 AM

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?

Login

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.