Important Update: CMS Policy Change on Cosmetic and Reconstructive Surgery Claims
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Attention Surgeons: A recent policy change by CMS in August 2023 now mandates the inclusion of a secondary diagnosis code alongside the primary for cosmetic and reconstructive surgery claims. Without this secondary code, your claim could be denied.
Key Points:
- Policy Change: Effective August 2023, CMS requires a secondary diagnosis code for cosmetic and reconstructive surgeries.
- Claim Denials: Absence of this secondary code will result in claim denials.
- Insurance Company Discretion: Health insurers may choose to follow this CMS policy. Notification will be provided if they adopt this change.
- Action Required: Ensure that a secondary diagnosis code is included in your claims to avoid denials.
Article – Billing and Coding: Cosmetic and Reconstructive Surgery (A58774) (cms.gov)
