Wiki ICD10 Denials for Z00.00

RondaTews

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Is anyone else receiving denials for ICD10 diagnosis Z00.00? We have received denials from two different payers when both of the payers covered ICD9 diagnosis V70.0 before Oct. 1st.
 
Z00.00 Denial

We called BC/BS today and they are going to reprocess- said it was processed incorrectly. But when we called on the Tricare denial they stated we need another diagnosis on the claim along with the Z00.00 which does not make sense to me.
 
Especially when there is no other diagnosis to use! You will need to appeal that one with a copy of the page from the code book maybe where the category description of the Z00 clearly states withoutout complaint suspected or reported duagnosis.
 
We called BC/BS today and they are going to reprocess- said it was processed incorrectly. But when we called on the Tricare denial they stated we need another diagnosis on the claim along with the Z00.00 which does not make sense to me.

In our pre- ICD-10 experience with Tricare (ICD-9) we received several correspondence asking for a screening code. When we would call the rep would say they wanted to know what we were screening for. This would even be in situations where the patient presents with pain and is diagnosed with a fracture. After battling with them for a while they finally stated in their correspondence that we should be using ICD-9 code V82.89.
 
Just a thought but maybe the issue is that they have already had their well visit for the year and using the dx before they are eligible for another well visit is causing the denial.
 
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