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Non-billable ICD-9 Codes

Bugs, Known Issues, Open Cases

Last Post by Anonymous 1 second ago

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hadams

(@hadams)

Posts: 10

Active Member

Topic starter

We are having a number of billing claims reject for invalid ICD-9 codes. When I research the codes online it indicates that the code is non-billable. However, when I search the V12.07 reference list the problems/codes are available for a provider to select.

How do I get these codes off of the reference list? Providers are going to assume that because it came up on a search, it is eligible for them to select and bill for.

Our provides are only using the Smart List and Reference List for searching, and this is causing issues with the billing of claims because then a provider needs to re-code their note in order for the bill to be submitted to insurance.

Some code examples: 371.0, 372.0, 716.9

Heather

Posted : February 16, 2015 7:23 am

ljburnham

(@ljburnham)

Posts: 331

Reputable Member

I have been told by GE that we can't change the reference list. We created custom lists that our Providers use. I made sure all the ICD 9's have matching 10's.

Posted : February 16, 2015 8:30 am

lkeith

(@lkeith)

Posts: 457

Honorable Member

So what good is the smart list if you still have to revert back to custom lists? We have an issue with codes that need a 4th or 5th digit to be valid, but they are still showing the 3 or 4 digit codes in the chart as 'valid'. We were told that if we mark that code as Inactive in the PM side, then it would not be prompted in the chart. Of course if there is a patient with the 3 or 4 digit code already on their problem list, we would have to go correct it there.

We have done some of that but I haven't heard any feed back as to if it works. Thinking about it now, the codes such as V12.07 may be a valid code, but it may be for hospital billing. Those codes we don't have set up in our PM but they still show in the chart side. That may be all for not ....

Posted : February 17, 2015 11:02 am

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