Something that we see frequently is multiple diagnosis codes related to the same body area being selected and billed on the claim. Most commonly:
J02.0: Streptococcal pharyngitis
J02.9: Acute pharyngitis, unspecified
J03.90: Acute tonsillitis, unspecified
R07.0: Pain in throat
Since these diagnosis codes are related to the same body area, describing the same issue, we are seeing insurance deny whole claims when 2 or more of these diagnosis codes are billed together. Only one of these is necessary for the claim.
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