Medical Billing Forum

Billing => Facility Billing => Topic started by: ONCUSER on March 31, 2011, 08:58:30 AM

Title: Medicare appealing
Post by: ONCUSER on March 31, 2011, 08:58:30 AM
We are a Cancer Center and a dental abscess service was addressed by the oncologist, so it the dental abscess was coded along with the office visit. Now Medicare has denied the claim because 525.5, a dental diagnosis is listed on the claim. We can't take out the dental dx because MD did addressed it.

By the way, this job was dumped on me so any help would be greatly appreciated.

oncuer.
Title: Re: Medicare appealing
Post by: Michele on March 31, 2011, 09:13:56 AM
Is the 525.5 the primary DX?
Title: Re: Medicare appealing
Post by: ONCUSER on March 31, 2011, 01:33:48 PM
No, it's the 4th. primary is carcinoma.
Title: Re: Medicare appealing
Post by: Michele on April 01, 2011, 01:37:42 PM
Wow, if it's not the primary dx I can't believe Medicare is rejecting for that reason.  I would call and speak to a Medicare customer service rep and verify that the dx is the reason for the denial.