E/M with E66.9

[rothja01]

Wondering if anyone has seen denials for BCBS when an outpatient provider is billing and E/M code with the primary diagnosis code of E66.9, obesity unspecified. I am assuming the denial 167 -DX noncovered, is the denial because the diagnosis is unspecified. I have not found denials from BCBS when the diagnosis is more specific, such as E66.1. Has anyone else had this experience?

 

[agm@claimsmedinc.com]

Wondering if anyone has seen denials for BCBS when an outpatient provider is billing and E/M code with the primary diagnosis code of E66.9, obesity unspecified. I am assuming the denial 167 -DX noncovered, is the denial because the diagnosis is unspecified. I have not found denials from BCBS when the diagnosis is more specific, such as E66.1. Has anyone else had this experience?

Yes, we got the same. You can try with E66.3

 

[antoniamay]

I believe its because it is listed as a Questionable Primary DX, you could list something else as the primary dx like the Encounter for Dietary counseling and surveillance - Z71.3