Wiki Ventricular Tachycardia Denials

[lbyrne13]

Since the codes for ventricular tachycardia changed and gained a 5th character, they always seem to be denied. Both unspecified I47.20 and other I47.29. I can't seem to figure out why. It's on E/M charges, cath/PCI charges, EKGs. Practically anytime I use it, (and my docs love to use it) it gets denied for submission error. I don't have any pregnancy complications to code first, it's mostly Medicare/Advantage patients. I have an E/M, cath, EKG, for the same pt, I47.29 is the only code used. I have other patients with multiple dx codes. What am I missing?

 

[thomas7331]

If your claim's date of service is after the code update and the denial is stating that the new ICD-10 code is invalid, then that is the payer's error. It's common after a code update for some payers to make these errors when they haven't updated their systems on time.

I imagine that all payers should have updated their systems by now since we're already four months into the new codes, so if your claims still haven't been adjusted, then you probably need to contact the payer to bring it to their attention and request that they reverse the denial.

 

[alysenb]

I had this issue because the payer was very delayed in updating their system with the new codes. They admitted it was their fault. My claims are finally being reprocessed.