The Most Likely Outcome of an Insurance Claim Submitted with a Diagnosis

The most likely outcome of an insurance claim submitted with a diagnosis code of a sore throat and a treatment code indicating a cast for a broken leg would be ____.

A) coverage at 100 percent for both the sore throat and the broken leg
B) the fee for service would be applied toward the patient's deductible
C) denied because the treatment was not medically necessary based on the diagnosis
D) a reprimand to the physician for not treating the sore throat
E) the patient may have to pay a coinsurance after the deductible is met