Medicare is denying these two CPTs due to not deemed as medical necessity. Not really into coding. So any thoughts can help. ICD 10 Diagnosis Codes ADS Healthcare Provider Hub DYK: CMS requires Medicare Advantage organizations (MAOs) to maintain compliance programs that prevent, detect and correct fraud, waste and abuse and audit diagnosis data before and after risk adjustment submissions. To support these CPT Code 93458: Billing Guidelines, Modifiers & Medicare Pay Important Update for Medi Cal Rx Providers Starting in mid 2026, ICD 10 diagnosis codes will be required for all pharmacy claims. To help facilitate a smooth transition, we need to hear from you!