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Denial code CO151 for chiro

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weirdomommy:
Hello all! This is my first post so please be gentle  . I received an EOB for 2 medicare patients with co151 denial code. I am well versed on medicare visit limits and we are sure to stay within those guidelines so I am perplexed as to why they denied. On the first patient, who has had 11 visits we billed codes 98940 AT, G8730 & G8942, one dos.  The second patient has had 12 visits with one set of dx's and 4 visits under a second set of dx's. Both containing sciatica. Any help is appreciated!

Michele:
Are you familiar with the LCD for 98940?  That is helpful in determining if the dx codes on the claim support the number of visits.  Since I don't know the dx codes it's hard to be very helpful.  Also, I'm assuming initial treatment dates are entered correctly?  For example, if a patient has a change of dx codes the initial treatment date would change to the date of the change of dx.

HOpe that helps!

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