pre-existing condition

[kkcvmt]

Is there any legal way to re-bill with a new code for a code denied on the basis of a pre-existing condition? This is a mental health condition for which there are other codes that could legitimately be used to refer to the the condition for which treatment was completed that would would not be denied based on a pre-existing condition. Thank you for your help.

[PMRNC]

No, you cannot change a code on the basis of gaining reimbursement. Besides most mental health conditions deemed pre-x will be linked, you could red flag the claim by changing the diagnosis and that would cause the carrier to request the chart notes which could make the situation worse. You can however bill the patient for anything denied for pre-x.