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07/12/2017

Billing CPT Code 28190 with Diagnosis S90.851A

We are billing cpt code 28190 with diagnosis S90.851A and/or S91342D and the insurance is denying stating not valid diagnosis stating that t his procedure and diagnosis do not match are there other diagnosis's which would be appropriate for this cpt code?

CPT Code 28190 and S90.851A is a valid combination. You wouldn’t bill both diagnoses provided above, as one is for the initial encounter and the other is for a subsequent encounter. CMS does not have a LCD policy for 28190 so Magnacare would need to be questioned, as to what policy they are referring to.

Below is a list of diagnostic codes that would be applicable to this procedure:

 

L08.89

Other specified local infections of the skin and subcutaneous tissue

L92.3

Foreign body granuloma of the skin and subcutaneous tissue

M60.20

Foreign body granuloma of soft tissue, not elsewhere classified, unspecified site

M60.271

Foreign body granuloma of soft tissue, not elsewhere classified, right ankle and foot

M60.272

Foreign body granuloma of soft tissue, not elsewhere classified, left ankle and foot

M60.279

Foreign body granuloma of soft tissue, not elsewhere classified, unspecified ankle and foot

M60.28

Foreign body granuloma of soft tissue, not elsewhere classified, other site

M79.5

Residual foreign body in soft tissue

S90.451A

Superficial foreign body, right great toe, initial encounter

S90.452A

Superficial foreign body, left great toe, initial encounter

S90.453A

Superficial foreign body, unspecified great toe, initial encounter

S90.454A

Superficial foreign body, right lesser toe(s), initial encounter

S90.455A

Superficial foreign body, left lesser toe(s), initial encounter

S90.456A

Superficial foreign body, unspecified lesser toe(s), initial encounter

S90.851A

Superficial foreign body, right foot, initial encounter

S90.852A

Superficial foreign body, left foot, initial encounter

S90.859A

Superficial foreign body, unspecified foot, initial encounter

S90.929A

Unspecified superficial injury of unspecified foot, initial encounter

S90.933A

Unspecified superficial injury of unspecified great toe, initial encounter

S90.936A

Unspecified superficial injury of unspecified lesser toe(s), initial encounter

S91.121A

Laceration with foreign body of right great toe without damage to nail, initial encounter

S91.122A

Laceration with foreign body of left great toe without damage to nail, initial encounter

S91.123A

Laceration with foreign body of unspecified great toe without damage to nail, initial encounter

S91.124A

Laceration with foreign body of right lesser toe(s) without damage to nail, initial encounter

S91.125A

Laceration with foreign body of left lesser toe(s) without damage to nail, initial encounter

S91.126A

Laceration with foreign body of unspecified lesser toe(s) without damage to nail, initial encounter

S91.129A

Laceration with foreign body of unspecified toe(s) without damage to nail, initial encounter

S91.141A

Puncture wound with foreign body of right great toe without damage to nail, initial encounter

S91.142A

Puncture wound with foreign body of left great toe without damage to nail, initial encounter

S91.143A

Puncture wound with foreign body of unspecified great toe without damage to nail, initial encounter

S91.144A

Puncture wound with foreign body of right lesser toe(s) without damage to nail, initial encounter

S91.145A

Puncture wound with foreign body of left lesser toe(s) without damage to nail, initial encounter

S91.146A

Puncture wound with foreign body of unspecified lesser toe(s) without damage to nail, initial encounter

S91.149A

Puncture wound with foreign body of unspecified toe(s) without damage to nail, initial encounter

S91.221A

Laceration with foreign body of right great toe with damage to nail, initial encounter

S91.222A

Laceration with foreign body of left great toe with damage to nail, initial encounter

S91.223A

Laceration with foreign body of unspecified great toe with damage to nail, initial encounter

S91.224A

Laceration with foreign body of right lesser toe(s) with damage to nail, initial encounter

S91.225A

Laceration with foreign body of left lesser toe(s) with damage to nail, initial encounter

S91.226A

Laceration with foreign body of unspecified lesser toe(s) with damage to nail, initial encounter

S91.229A

Laceration with foreign body of unspecified toe(s) with damage to nail, initial encounter

S91.241A

Puncture wound with foreign body of right great toe with damage to nail, initial encounter

S91.242A

Puncture wound with foreign body of left great toe with damage to nail, initial encounter

S91.243A

Puncture wound with foreign body of unspecified great toe with damage to nail, initial encounter

S91.244A

Puncture wound with foreign body of right lesser toe(s) with damage to nail, initial encounter

S91.245A

Puncture wound with foreign body of left lesser toe(s) with damage to nail, initial encounter

S91.246A

Puncture wound with foreign body of unspecified lesser toe(s) with damage to nail, initial encounter

S91.249A

Puncture wound with foreign body of unspecified toe(s) with damage to nail, initial encounter

S91.321A

Laceration with foreign body, right foot, initial encounter

S91.322A

Laceration with foreign body, left foot, initial encounter

 

S91.329A

Laceration with foreign body, unspecified foot, initial encounter

 

S91.341A

Puncture wound with foreign body, right foot, initial encounter

 

S91.342A

Puncture wound with foreign body, left foot, initial encounter

 

S91.349A

Puncture wound with foreign body, unspecified foot, initial encounter

 

 

 

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