Daniel y Posted Wed 11th of April, 2012 13:51:58 PM
I just received the denial with explanation as 368.00 is not a medical diagnosis code. Is 368.00 consider vision or medical diagnosis code?
SuperCoder Answered Wed 11th of April, 2012 15:10:50 PM
This is an nonspecific code. Your claim may be held up by insurance companies or third-party payors for further documentation before payment is made.
Nonspecific Code: These have a square before the code to indicate that although these codes are valid as a principal (fi rst-listed) diagnosis,they are usually too general to be used as a first-listed diagnosis for Medicare, and you should continue to seek a code that is more specific.
Payors may not be able to determine 'medical necessity' because the code is too generic