Wiki Denial for ICD 10 codes- B18.1, K75.9, R74.01

[patdow]

We have received 3 denials due to “Diagnosis code incorrectly coded per ICD10 manual” from Ambetter.

The CPT code is 99204.
First, I coded B18.1 then K75.9. It denied due to icd 10 codes.

Then, I coded K75.9 then B18.1. I only switched the 2 around. It denied due to icd 10 codes.

Lastly, I found that the pt had elevated liver enzymes so I coded R74.01 then B18.1 then K75.9. It denied due to icd 10 codes.

I have used all these codes before with no issue. Can someone please advise on what I’m doing wrong and what I need to change?

 

[sls314]

We have received 3 denials due to “Diagnosis code incorrectly coded per ICD10 manual” from Ambetter.

The CPT code is 99204.
First, I coded B18.1 then K75.9. It denied due to icd 10 codes.

Then, I coded K75.9 then B18.1. I only switched the 2 around. It denied due to icd 10 codes.

Lastly, I found that the pt had elevated liver enzymes so I coded R74.01 then B18.1 then K75.9. It denied due to icd 10 codes.

I have used all these codes before with no issue. Can someone please advise on what I’m doing wrong and what I need to change?

B18.1 should be the only diagnosis code on the claim.

K75.9 is Hepatitis unspecified. It's redundant to add Hepatitis, unspecified (K75.9) along with a specified type of Hepatitis (B18.1)

Refer to the Excludes notes for K75.9. There's an Excludes1 note for Viral Hepatitis B15-B19.

 

[patdow]

B18.1 should be the only diagnosis code on the claim.

K75.9 is Hepatitis unspecified. It's redundant to add Hepatitis, unspecified (K75.9) along with a specified type of Hepatitis (B18.1)

Refer to the Excludes notes for K75.9. There's an Excludes1 note for Viral Hepatitis B15-B19.

View attachment 7569

Thank you!