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How should I bill 67914 to Medicare?

Marina Posted Tue 17th of September, 2013 14:12:44 PM

I billed codes 67914-e2 and 67914-e4 along with codes 68801-e2 and 68801-e4 with DX code 375.22 to Medicare. Medicare paid for 68801, however, Medicare did not pay for codes 67914 with reason "These are non-covered because this is not deemed a medical necessity by the payer". Do I need to send supporting documents? Does Medicare only allow certain diagnosis codes for this procedures?

SuperCoder Answered Tue 17th of September, 2013 19:34:28 PM

Absolutely. With 67914 only these medical necessity codes are payable. This is actually a ectropion repair code

374.10 Ectropion unspecified
374.11 Senile ectropion
374.12 Mechanical ectropion
374.13 Spastic ectropion
375.51 Eversion of lacrimal punctum

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