1. Kelly Drouncheck
   Posted 1 year ago #
   

   This was originally coded by another cooworker who no longer resides and I am new to surgery coding so can someone help me find out why I cannot get '11301' and '11302' covered. After a review was sent, MCR rejected COB15, requires qualifying service. This is how the claim was originally sent.

   PAID- '99211', 25 mod, Dx 709.3, 285.29, v586.9
   NOT PAID-'11301', 51 mod, Dx 702.11 w/ note R knee .4, L knee .5
   NOT PAID-'11302', 51 mod, Dx 702.11 w/ note R arm 1.2
   PAID- '17000', 51 mod, Dx 709.9 w/ note Leg
   PAID- '17003', 51 mod, Dx 709.9 w/ Legx3 Bilat LE
   NOT PAID-'J2001', Dx 709.3

   If anyone needs more details please let me know. I am desperate for advice.

2. SuperCoder
   Posted 1 year ago #
   

   Use of ICD-9-CM 702.11, inflamed seborrheic keratosis, is insufficient to justify lesion removal without medical documentation of the patient's symptoms and physical findings. This lesion must show one or more of the following characteristics: bleeding, intense itching, pain, change in physical appearance (reddening or pigmentary change), recent enlargement, increase in numbers, physical evidence of inflammation or other.

3. Kelly Drouncheck
   Posted 1 year ago #
   

   Not sure that is the answer. 702.11 is listed on this LCD for these services. Anyone else want to give it a shot?

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