Wiki Covid Follow up visits

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chelsea.meetin@gmail.com

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I am getting denials when trying to bill a covid follow up visit. Per the updates webinar, we are supposed to bill
1. z09 (encounter for f/u exam)
2. z86.16 (personal hx of covid 19)
and I am also billing z02.5 (return to sports clearance)

I got a denial sending it that way for primary dx. I tried sending with z86.16 as primary, and they denied it again for the same reason, principal dx.

What am I doing wrong here? Any ideas?
 
There is U09.9 that started in October, the ICD-10 renews in October. So i don't know what DOS you have on your claim but take a look at the new guidelines and see if a different U code would be more appropriate.
 
chelsea.meetin@gmail.com said:
I am getting denials when trying to bill a covid follow up visit. Per the updates webinar, we are supposed to bill
1. z09 (encounter for f/u exam)
2. z86.16 (personal hx of covid 19)
and I am also billing z02.5 (return to sports clearance)

I got a denial sending it that way for primary dx. I tried sending with z86.16 as primary, and they denied it again for the same reason, principal dx.

What am I doing wrong here? Any ideas?
Click to expand...
For guidelines 9/2020-10/2021 ) Follow-up visits after COVID-19 infection has resolved For individuals who previously had COVID-19 and are being seen for follow-up evaluation, and COVID-19 test results are negative, assign codes Z09, Encounter for follow-up examination after completed treatment for conditions other than malignant neoplasm, and Z86.16, Personal history of.

For Guidelines 9/2021-10/2022 is the same as above. THE POST COVID CODE U09.9 IS FOR If an individual with a history of COVID-19 develops MIS, assign codes M35.81, Multisystem inflammatory syndrome, and U09.9, Post COVID-19 condition, unspecified.

Is this a inpatient or outpatient visit? and is the primary reason COVID follow up ? some payers will deny visits that may have the same dx on previous visit.
 
IndepCoder said:
For guidelines 9/2020-10/2021 ) Follow-up visits after COVID-19 infection has resolved For individuals who previously had COVID-19 and are being seen for follow-up evaluation, and COVID-19 test results are negative, assign codes Z09, Encounter for follow-up examination after completed treatment for conditions other than malignant neoplasm, and Z86.16, Personal history of.

For Guidelines 9/2021-10/2022 is the same as above. THE POST COVID CODE U09.9 IS FOR If an individual with a history of COVID-19 develops MIS, assign codes M35.81, Multisystem inflammatory syndrome, and U09.9, Post COVID-19 condition, unspecified.

Is this a inpatient or outpatient visit? and is the primary reason COVID follow up ? some payers will deny visits that may have the same dx on previous visit.
Click to expand...
If you still need help contact me anytime. Thank you
 
I believe the denial might be due to your dx Z09 and Z02.5 - I believe the coding guidelines states Z02.5 may only be reported as the principal/first-listed diagnosis and Z09 is usually the sequenced as the primary dx.

If they are just getting cleared for sports due to recently having COVID-19, we usually use Z09 and Z86.16 as the dx for the encounter. I don't think you need the Z02.5

 
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