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Watchman denials for dx I48.19

Date: Jan 7, 2020

Question:

The Watchman procedures that we have billed since 10/01/19 for diagnosis I48.19 are not on the NCD 20.34. They are requesting that we change it to I48.1. As you know an additional 5th digit is now required for this code due to coding update 10/01/19. The NCD has not been updated to reflect this change according to our MAC, which is CGS. Is the only way to get this paid is do an appeal? Do you have any information or suggestions on how to handle this issue? At this time we have 6 claims that are not paying.

Question ID : 13433
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