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Paula Posted Thu 19th of November, 2015 15:49:11 PM

I need help with the icd10 dx code for this one.

Billed 27822 78
97605 59

Medicare replacement denied 97605 59 stating 97605 has not met the associated dx code relationship criteria for CMS ID L35125.

Procedure performed: Open reduction and internal fixation of the right trimalleolar ankle fracture dislocation with fixation of the medial and lateral malleolionly.
2. Debridement of right ankle skin down through the dermis with placement of wound VAC.

For 97605 59 we used dx: L89.513 & S82.851 D which was denied.

Thank You,
Center For Orthopaedic Surgery & Sports Medicine

SuperCoder Answered Fri 20th of November, 2015 07:28:53 AM


As per CMS, Providers should continue to submit ICD-10-CM diagnosis codes without decimals on their claim forms and electronic claims.

No procedure code to diagnosis code limitations are being established at this time.

Please check your claim form with correct CPT and ICD codes and bill it again. if you will get denied again, the appeal to medicare.

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