Wiki Dementia Codes

Messages
5
Location
Georgetown, KY
Best answers
0
Is anyone aware of a change in coding dementia codes? I've had several denials this week on code F03.B4. The denial states that it's missing/incomplete/invalid principal diagnosis.
 
Is anyone aware of a change in coding dementia codes? I've had several denials this week on code F03.B4. The denial states that it's missing/incomplete/invalid principal diagnosis.
We have had this with Humana lately on all of the dementia codes that start with F03. Not sure what’s going on because I haven’t seen any updates. I know many payers don’t allow unspecified codes, but sometimes the F03 series for dementia is as specific as you can get.
 
We have had this with Humana lately on all of the dementia codes that start with F03. Not sure what’s going on because I haven’t seen any updates. I know many payers don’t allow unspecified codes, but sometimes the F03 series for dementia is as specific as you can get.
Yes, it is Humana that I'm having the issue with too.
 
I'm seeing this too, with several dementia codes. Also many are now marked as an invalid principal diagnosis in Encoder Pro as well I've noticed. I'm wondering if this is related....
 
This CR memo from MCR changed the status for F03.- I feel like this may be the underlying culprit but still ultimately wrong. Like MCR made an oopsy and no one has caught it yet.
Thanks for pointing that out, I totally missed that. What's strange is we don't have issues w/ the Medicare claims, it's only Humana. Any ideas on how we could request an update to fix this issue?
 
Thanks for pointing that out, I totally missed that. What's strange is we don't have issues w/ the Medicare claims, it's only Humana. Any ideas on how we could request an update to fix this issue?
Not really no. I'm still learning related to the denials side of it which is why I came here to see if anyone has any tips. Currently I'm just pushing back to AR and asking them to review with payer. Not sure what else I can do
 
Is anyone aware of a change in coding dementia codes? I've had several denials this week on code F03.B4. The denial states that it's missing/incomplete/invalid principal diagnosis.
Hi Cgates1976
If look in the ICD10 manual they want underlying reason person has dementia first. Hopefully provider has given you this data. Also there are few types of dementia& underlying reasons. Dementia Dx Blocks F02, F03, F06, Some reasons can be head injury S06, medicationsT36 orT50, alcoholism,F10 senile R41 or G31, due to lupusM32 or stroke I69, Parkinson Ds G20, and Etc
I hope helped you
Lady T
 
Top