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public:gorev:cas:11 [2017/11/01 14:49] (current)
bgriffin created
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 +===== CAS Code 11 diagnosis is inconsistent with procedure code =====
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 +This cas code indicates the diagnosis code used has thrown a specific payer edit stating the procedure CPT you have billed is not payable with the diagnosis code(s) you have submitted. ​    
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 +Majority of the time this is caused by have a "​Z",​ "​E"​ or other diagnosis codes that are not likely to be acceptable as a primary diagnosis. ​  In these scenarios you need to review coding and code with a more accurate pdx.   One example of this, you run an imaging center, a claim denies with CAS 11, your claim was coded out with a PDX of Z01.818 (encounter for preprocedural examination),​ the physician order states lower back pain, left knee pain, etc.  You need to code utilizing these more accurate dxs.
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 +Findacode is the best procedure lookup tool on the market and can easily help your coders see this before claims are released.
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 +[[http://​www.findacode.com?​pc=GLOBONICS|Find-A-Code]]
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