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94060

Marilyn Posted Sun 19th of January, 2014 19:21:03 PM

Why is it that all of a sudden "786.2" is being denied by Medicare as service lacks information for adjudication?

SuperCoder Answered Wed 22nd of January, 2014 04:06:38 AM

Check in your state and carrier's LCD policy if that supports the ICD code. Many states and MAC support this ICD against the CPT 94060. If MCR still rejects it, appeal citing the LCD policy and ask for a directive in writing.

Marilyn Posted Wed 22nd of January, 2014 12:19:03 PM

This is for state of AR. When I looked up icd-cross referencing 94060, what does it mean when the dx code is highlighted in blue?

SuperCoder Answered Thu 23rd of January, 2014 09:51:15 AM

I assume that your MAC is Novitas (no. 07102), and LCD ID is 32762. The code 786.2 is included in the ICD list. There is no meaning for ICD codes in blue (just to indicate that it's a hyperlinked code & would take you to detail page of the ICD, if clicked).

We would suggest to re-submit the claim with a copy of LCD page showing 786.2 as valid ICD code against 94060 in Arkansas, with a copy of medical records documenting COUGH (786.2) as a direct diagnosis. If still rejected, ask for a directive in writing.

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