Q14.0 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM Q14.0 became effective on October 1, 2021. This is the American ICD-10-CM version of Q14.0 - other international versions of ICD-10 Q14.0 may differ. congenital malformation of larynx ( Q31.-)
Q14.0 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2018/2019 edition of ICD-10-CM Q14.0 became effective on October 1, 2018. This is the American ICD-10-CM version of Q14.0 - other international versions of ICD-10 Q14.0 may differ.
I used CPT 56700 partial hymenectomy and Dx N89.8 other specified noninflammatory disorders of vagina. I used that Dx because ICD-9 623.8 was for hymenal tag and this is the closest crosswalk that I could get that matched what the patient has. Tricare has denied the claim stating the diagnosis code is inconsistent with the procedure.
When the diagnosis is an RD, the correct CPT code is 67110. This code is bundled by the NCCI with either 67105 (laser) or 67101 (cryotherapy) performed during the same session. If the diagnosis is subretinal hemorrhage or vitreomacular traction, the correct CPT code is 67025.
If the diagnosis is subretinal hemorrhage or vitreomacular traction, the correct CPT code is 67025.
67210: Destruction of localized lesion of retina (eg, macular edema, tumors), one or more sessions; photocoagulation.
If vitrectomy is performed with the removal of the internal limiting membrane for the repair of a MH, the CPT code that should be used is 67042 —vitrectomy, mechanical, pars plana approach; with removal of internal limiting membrane of retina (eg, for repair of MH, diabetic macular edema), includes, if performed, intraocular tamponade (ie, air, gas or silicone oil).
If the diagnosis is epiretinal membrane, and a PPV with membrane peel is performed, the correct CPT code would be 67041 —vitrectomy, mechanical, pars plana approach; with removal of preretinal cellular membrane (eg, macular pucker).
What to Consider: In this case, the diagnosis leading to the laser procedure is CNVM. The correct CPT code is 67220.
Although the same laser may be used in the clinic, multiple CPT codes may be considered, and the correct one is determined based on the reason for treatment.