General Question for the Week of July 26, 2021

General Compliance Question of the Week

Question:

Pre-MRI screening orbit x-rays – we keep getting denials for using T15.90XA due to being unspecified. Do you know what other codes would be appropriate? Would Z18.10 be a useable code for this T15.90XA Foreign body on external eye, part unspecified, unspecified eye, initial encounter Z18.10 Retained metal fragments, unspecified

Answer:

You may get denied regardless of the diagnosis you use as this is often considered a screening exam. You should report the diagnosis that is specific to the patient. If you know they have retained metal fragments, then Z18.10 would be appropriate. But if it is just suspected that there may be metal fragments, then a diagnosis code from the Z03.82- section could be more appropriate. Other codes might be appropriate depending on the patient’s specific circumstances.