William Ivan Posted Tue 29th of January, 2019 10:24:36 AM
Good morning: Humana recently denied a claim 93880 with dx i65.21 i65.22 Stating missing/incomplete dx. Could you provide guidance?
SuperCoder Answered Wed 30th of January, 2019 07:43:58 AM
Thank you for your Question.
There is no specific guideline found for Humana Insurance stating missing or incomplete diagnosis code for this specific CPT code 93880. Some payers deny the claim if the bilateral code present for the codes that have laterality and you bill laterality codes instead of bilateral diagnosis. I65.21 and I65.22 seems appropriately billable codes with CPT code 93880. You can re-appeal this claim with diagnosis code I65.23 Occlusion and stenosis of bilateral carotid arteries if the documentation supports for bilateral occlusion of carotid arteries. Also, Check with you payer for specific diagnosis codes payable with this CPT 93880 to prevent future denial on these type of claims.
Hope this Helps!