Forum - Questions & Answers

Feb 9th, 2012 - swalker216

encoder

Does anyone have access to encoder. I have a pt that has caresource and I am having trouble with CPT® Code 27598 and 28043. Every Dx that I try Caresource denies and Dx not payable with Procedure code. They said that they use encoder.
I dont have this. I was just wondering if anyone has it if they could put in those 2 procedure codes and give me a range of what Dx Codes I need to be looking at.
I have tried 893.1 249.80 997.62 730.27 892.1 892.0 997.69 730.07 and none of these are payable for those CPT® Codes

Thanks

Feb 9th, 2012 - koatsj 160 

re: encoder

CPT® 27598........ CODES IN ENCODERPRO
170.7 Malignant neoplasm of long bones of lower limb
195.5 Malignant neoplasm of lower limb
198.5 Secondary malignant neoplasm of bone and bone marrow
249.70 Secondary diabetes mellitus with peripheral circulatory disorders, not stated as uncontrolled, or unspecified
249.71 Secondary diabetes mellitus with peripheral circulatory disorders, uncontrolled
249.80 Secondary diabetes mellitus with other specified manifestations, not stated as uncontrolled, or unspecified
249.81 Secondary diabetes mellitus with other specified manifestations, uncontrolled
250.70 Diabetes with peripheral circulatory disorders, type II or unspecified type, not stated as uncontrolled
250.71 Diabetes with peripheral circulatory disorders, type I [juvenile type], not stated as uncontrolled
250.72 Diabetes with peripheral circulatory disorders, type II or unspecified type, uncontrolled
250.73 Diabetes with peripheral circulatory disorders, type I [juvenile type], uncontrolled
250.80 Diabetes with other specified manifestations, type II or unspecified type, not stated as uncontrolled
250.81 Diabetes with other specified manifestations, type I [juvenile type], not stated as uncontrolled
250.82 Diabetes with other specified manifestations, type II or unspecified type, uncontrolled
250.83 Diabetes with other specified manifestations, type I [juvenile type], uncontrolled
440.20 Atherosclerosis of native arteries of the extremities, unspecified
440.21 Atherosclerosis of native arteries of the extremities with intermittent claudication
440.22 Atherosclerosis of native arteries of the extremities with rest pain
440.23 Atherosclerosis of native arteries of the extremities with ulceration
440.24 Atherosclerosis of native arteries of the extremities with gangrene
443.1 Thromboangiitis obliterans (Buerger's disease)
443.81 Peripheral angiopathy in diseases classified elsewhere
682.6 Cellulitis and abscess of leg, except foot
730.16 Chronic osteomyelitis, lower leg
731.1 Osteitis deformans in diseases classified elsewhere
731.3 Major osseous defects
731.8 Other bone involvement in diseases classified elsewhere
733.43 Aseptic necrosis of medial femoral condyle
785.4 Gangrene
891.1 Open wound of knee, leg (except thigh), and ankle, complicated
897.3 Traumatic amputation of leg(s) (complete) (partial), unilateral, at or above knee, complicated
928.10 Crushing injury of lower leg
928.11 Crushing injury of knee

CPT® 28043.......CODES FROM ENCODERPRO
171.3 Malignant neoplasm of connective and other soft tissue of lower limb, including hip
172.7 Malignant melanoma of skin of lower limb, including hip
195.5 Malignant neoplasm of lower limb
198.89 Secondary malignant neoplasm of other specified sites
209.34 Merkel cell carcinoma of the lower limb
209.75 Secondary Merkel cell carcinoma
214.1 Lipoma of other skin and subcutaneous tissue
215.3 Other benign neoplasm of connective and other soft tissue of lower limb, including hip
238.1 Neoplasm of uncertain behavior of connective and other soft tissue
239.2 Neoplasms of unspecified nature of bone, soft tissue, and skin

Feb 9th, 2012 -

re: encoder

Thank you so much. This really helps

Feb 9th, 2012 - koatsj 160 

re: encoder

you are welcome.



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