Wiki BlueCross & BlueShield O80 and O82 not specific enough

cmancino

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Hello,
My doctors are from New York for global deliveries I use diagnosis O80 and outcome of delivery and gestational weeks, and for c-sections O82 and outcome of delivery and gestational deliveries the EOB is coming back as diagnosis is not specific. When I call they say the same thing even if the c-section was performed because arrest of descent and I bill that ICD 10 code O64.0xx1 still comes back as nonspecific. I have searched the policy and procedures and no policy change except for the medicaid hmo's revision on 2017. If anyone has any information or advice or help I would greatly appreciate it. Thank you for taking the time.
 
Hello,
My doctors are from New York for global deliveries I use diagnosis O80 and outcome of delivery and gestational weeks, and for c-sections O82 and outcome of delivery and gestational deliveries the EOB is coming back as diagnosis is not specific. When I call they say the same thing even if the c-section was performed because arrest of descent and I bill that ICD 10 code O64.0xx1 still comes back as nonspecific. I have searched the policy and procedures and no policy change except for the medicaid hmo's revision on 2017. If anyone has any information or advice or help I would greatly appreciate it. Thank you for taking the time.
I know this was posted a while back, but sometimes your weeks of gestation can cause the problem. If the patient delivered early (if Medicaid prior to 39 wga) you have to make sure the 1st listed diagnosis gives the reason for the early delivery -- such as was she in labor (see O 42 codes.)
 
Thank you for answering believe it or not its the commercial policies giving me the hard time not the medicaid or medicare ones I have searched policies guidelines and no policy change that I can find.
 
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