Wiki Cigna denying F1220 as admitting dx code

[tmonroeca@gmail.com]

I work at an inpatient facility for substance abuse and my claims for residential level of care are making it through my clearinghouse, but being blocked by the payer CIGNA stating that the "admitting diagnosis code: invalid for payer."

The code DSM 5 Description for F1220 is for Cannabis use disorder, severe ...... but ICD-10 has it as Cannabis dependence, uncomplicated

Does anyone have any advice, as we have started seeing this issue since ICD-10 implementation with the admitting dx.

If anyone can help that would be great. My email is tmonroeca@gmail.com

 

[Cavalier40]

I remember Cigna doing something similar when I was first getting started with our detox. What are you using as your admission source?

 

[MrsJenVaughan]

Is the claim actually being denied with no EOB being received or is it being blocked internally on the electronic submission? If it is being blocked internally I would try a paper submission or calling the EDI department, but if the claim is being processed and denied I would try calling and seeing if a rep can manually send it back for reprocessing as it may just be a glitch in their system. I wish I could help more, but I haven't seen any of my doctors bill an F12.20, so far. Good Luck!