christiwithani
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I have a patient's claims that have been denied by Medicare due to the diagnosis not being on the LCD. I submitted a first level appeal that subsequently denied and am in the process of submitting a second level of appeal. I asked my provider to write a letter to support medical necessity; the patient was treated with IMRT, and now he is asking if we can just change the diagnosis code and rebill the claims. My understanding is that if there is a true clerical error I could have made the correction but I worry if I do that now, it will raise some red flags. Thoughts?