Managed Care, Billing, and Coding
Optos medical billing for 224.60
I am looking for a way to get medical insurances to accept and pay for 92250 with a diagnosis code of 224.60. It was been repeatedly denied, though we are sure to use all 5 digits. Any pointers would be appreciaed
More On: medical billing, optos
Comments
Location: Lake Oswego, OR
Posts: 4
First of all 224.60 does not
First of all 224.60 does not exist. The proper diagnosis code for Benign Choroidal Neoplasm is 224.6 (only 4 digits, not 5) The reason that most carriers will not cover this code is because photo's do not meet the requirement for Medical Necessity. In other words, the photos do not meet the standard of altering or planning treatment for this condition. A photo just to monitor the situation is not medically necessary.
Location: MATAWAN, NJ
Posts: 3
but if it changes in size and
but if it changes in size and the patient returns unsymptomatic then moves and it develops into a MM you're responsible. Seems crazy. The photo is a far better baseline for change then anything I can surely draw