Rank: Guest
Joined: 9/8/2012(UTC)
Posts: 2,195
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Hi,
I need help for this medical claim.
I have been trying submit the 3rd molar extraction to medical several times and insurance keep denied. The letter say need to include the appropriate ICD-10 codes and found that one or more of ICD-10 diagnosis code are illegible or missing from this claim.
I submitted the code as: K01.1 and D7220
Please advice what code need to add on or adjust, thanks.
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Rank: Administration
Joined: 11/21/2012(UTC)
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Hi guest!
Hm, interesting! The diagnosis code you provided, K01.1, is a valid & billable ICD-10 code, it stands for "impacted teeth".
A few questions to help figure out why they may be denying and stating it is related to the ICD-10 diagnosis code:
1) do you have a number 0 in the upper right hand corner of field 21, in the "ICD Ind" box?
2) do you have K01.1 listed in blank letter "A", the first one of the 12 blanks in field 21?
3) do you have the letter "A" in field 24E for diagnosis pointer?
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Rank: Guest
Joined: 9/8/2012(UTC)
Posts: 2,195
Was thanked: 16 time(s) in 15 post(s)
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1) do you have a number 0 in the upper right hand corner of field 21, in the "ICD Ind" box? NO
2) do you have K01.1 listed in blank letter "A", the first one of the 12 blanks in field 21? NO
3) do you have the letter "A" in field 24E for diagnosis pointer? NO
Do I need to fill anything?
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Rank: Administration
Joined: 11/21/2012(UTC)
Posts: 1,732
Thanks: 39 times
Was thanked: 51 time(s) in 51 post(s)
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Hi Guest! Ok great, yes you need all three of those items I mentioned to be completed on the CMS1500 medical claim in order for it to be processable. I have a feeling the denial response had more to do with missing entries rather than the code itself. It is also extremely important to have the rest of the medical claim completed properly in order for it to be processed. Once you have made those corrections, if you'd like to send along a copy of the claim to training@dentalwriter.com I would be happy to do a quick review of it for you.
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Rank: Guest
Joined: 9/8/2012(UTC)
Posts: 2,195
Was thanked: 16 time(s) in 15 post(s)
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