I have multiple payers denying claims with the new 2023 codes. Some are denying the claim per the LCD. The codes are correct and the LCD's have been updated. I tried submitting claim on the payer site using the 2022 code but it will not allow the ICD-10 codes as it is not effective for date of services. The payers are sending the claims back, I have appealed the claims, and I have contacted our local payer reps without any resolution. Any suggestions?
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Wiki New 2023 ICD-10 codes denying
- Thread starter jasonrme
- Start date
TThivierge
True Blue
Hi Jasonrme,
What are the particular dx codes? I know that most payers will deny Unspecified dx codes. But are your ICD10 codes very detailed in matching the providers documentation such as; types of heart attacks, pain in certain body areas of limbs vs stomach, certain diseases need infection codes added, types of hemorrhoids, Etc. Are the providers up to date with credentialing process with the payer ? Or are you billing most claims with non first listed Z codes as first on the claims. Maybe the ICD10 diseases are out of sequence? Well it could be the insurance company's algorithms are not up to date yet ...that probably give you some denials. I d write a nice letter but ask them if this is the problem. Plus payers like to slow up payments especially in these days of high inflation..
Don t shoot the messenger (me) just trying to help
Lady T
What are the particular dx codes? I know that most payers will deny Unspecified dx codes. But are your ICD10 codes very detailed in matching the providers documentation such as; types of heart attacks, pain in certain body areas of limbs vs stomach, certain diseases need infection codes added, types of hemorrhoids, Etc. Are the providers up to date with credentialing process with the payer ? Or are you billing most claims with non first listed Z codes as first on the claims. Maybe the ICD10 diseases are out of sequence? Well it could be the insurance company's algorithms are not up to date yet ...that probably give you some denials. I d write a nice letter but ask them if this is the problem. Plus payers like to slow up payments especially in these days of high inflation..
Don t shoot the messenger (me) just trying to help
Lady T