I have some claims that Affinity Medicaid has denied for the 10040 (Acne surgery) because the dx code L70.0 (Acne Vulgaris), is saying is not correct or incomplete. Has anybody else received this denial? L70.0 has always been paid with the acne surgery. There is no clinical policy on their website. I asked the rep and they told me to speak to the biller, however I am the biller. There are about 3-4 claims outstanding since Feb 2018. I’m thinking to appeal it with medical records.

Thanks,
Viviana