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Medicare denying CPT® 66984
I am getting claims put on hold for Medicare saying diagnosis code 366.16 does not justify procedure 66984 as well as the other cataract codes . LCD say's only good code is 362.51 Nonexudative senile macular degeneration of retina. Is this a miss print or is it for real? Any help would be apprieciated.
re: Medicare denying CPT® 66984
I checked my LCD, I am in Georgia her are my medically supported dx's:
ICD-9 Codes that Support Medical Necessity
364.23 LENS-INDUCED IRIDOCYCLITIS
365.51 PHACOLYTIC GLAUCOMA
366.00 - 366.9 NONSENILE CATARACT UNSPECIFIED - UNSPECIFIED CATARACT
367.31 ANISOMETROPIA
743.30 CONGENITAL CATARACT UNSPECIFIED
743.31 CONGENITAL CAPSULAR AND SUBCAPSULAR CATARACT
743.32 CONGENITAL CORTICAL AND ZONULAR CATARACT
743.33 CONGENITAL NUCLEAR CATARACT
743.34 CONGENITAL TOTAL AND SUBTOTAL CATARACT
743.36 CONGENITAL ANOMALIES OF LENS SHAPE
743.37 CONGENITAL ECTOPIC LENS
743.39 OTHER CONGENITAL CATARACT AND LENS ANOMALIES
998.82 CATARACT FRAGMENTS IN EYE FOLLOWING CATARACT SURGERY
re: Medicare denying CPT® 66984
Those were the ones we used to use. Our medicare person is going to call tomorrow tio see if this is right thanks
re: Medicare denying CPT® 66984
Something is not correct. 66984 is the code for cataract removal and so the diagnosis must be some type of cataract. 362.51 is the code for a retinal problem that has nothing to do with a cataract. You might want to check with your MAC to see why your claims are being put on hold. There might be some other type of problem.
re: Medicare denying CPT® 66984
we will be calling tomorrow thanks