Home Health ICD-9/ICD-10 Alert

Published on Mon Aug 24, 2009 PDF

Use 'Remarks' to add helpful details.

If you submit claims with diagnosis code V15.88, you should add more details on the claim to avoid hold-ups.

When regional home health intermediary Cahaba GBA receives claims with a trauma diagnosis code like V15.88 (Personal history of fall), it must research the claim to make sure another payor isn't liable under auto, liability, or workers' comp insurance, the intermediary explains in its August newsletter for providers.

Do this: "When submitting a claim with the V15.88 diagnosis code, include a note in the 'Remarks' field (FISS Page 04) acknowledging whether the services are related to a new injury and, if so, where the injury took place," Cahaba instructs.

Cahaba lists 10 place of occurrence diagnosis codes, ranging from E849.0 (Home) to E849.9 (Unspecified place), to identify where the injury took place. If no other insurer is liable, include a note in the "Remarks" field to explain why, Cahaba suggests.

For example, state that the patient fell on a certain date in the home and no other insurer was liable. Or indicate the patient is at risk for falls, but no fall occurred.

Tip: "Keep in mind that including information in the 'Remarks' field is always helpful in processing your Medicare claims," the RHHI reminds providers. "In addition, Cahaba encourages providers to review the 'Remarks' page when claims are in RTP as there may be instructions from our staff to assist in the successful adjudication of your Medicare claims." To see the article including the full list of place of occurrence diagnosis codes, go to www.cahabagba.com/rhhi/news/newsletter/200908_rhhi.pdf.