Medical Billing Forum
General Category => General Questions => : gbaird818 December 26, 2011, 10:33:13 PM
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I am working for a company that designs and fits Orthotic and Prosthetic devices. I was asked by the owner if there is a "crosswalk" that can be used for ICD-9 (ICD-10) and HCPCS codes. Does anyone have information regarding this type of a crosswalk that indicates if a particular diagnosis code is appropriate for the HCPCS code being used. My understanding is the ordering physician gives the DX code when ordering a certain devise, and when billing insurance, they are receiving denials. I am just beginning with this group and have never billed for orthotic and prosthetic devices. Any help or suggestions?
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So you are looking for something that tells you if a certain HCPCS code is covered for a specific ICD-9 code? I also understood that the dx came from the ordering physician as well, but most ordering physician's give a script with a handwritten diagnosis, not a code so it could be that the person converting the script to an ICD-9 is not using the appropriate code. For example, the Dr may write "diabetes" but we all know that there are MANY ICD-9's for many different types of diabetes, and some codes are covered for some, but not for all. It is important to get the right dx code. With that being said, I am not aware of a "crosswalk" for this. Is it one particular insurance carrier, or all across the board? I know we have the ability to look up info like that with our local BCBS, and Medicare you can go to the LCD/NCD's. If it is one particular carrier you could try contacting the provider rep to see if anything is available.