Wiki Who can help with ICD-10 enforcement?

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skeeley

skeeley

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I am having a problem with two different software companies that offer scrubbers to assist with submitting claims. (One of the two we are paying yearly to use) Neither one of these companies catch excludes 1 codes in their edits because they are stating the two codes can be used together. I have explained to them and given examples to no avail. Ex: D64 has excludes 1 (at the beginning of the section) for code (C92.0_ ). These two codes should not be billed together. They are insisting that D64.81 and C92.00 can be billed together. Any suggestions other that dropping both of them? I would hate for anyone else to be use these companies when both have a misunderstanding of this rule.
 
You might check to see if they are using the correct data base. Many software vendors work on an international basis and have been using ICD-10 for many years. They were under the mistaken notion that the U.S. would use this same code set. We are not, the U.S. is using ICD-10 CM, which is different in many ways from ICD-10. It is just a thought but I have found this to be very true in a dozen different instances so far.
 
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