10-13-2017, 06:48 AM | Community Wiki

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using other codes for diagnosis

  1. Default using other codes for diagnosis
    Medical Coding Books
    we are having claims rejected and sent to our workque, when using other for a diagnosis. ie: r31.2 other microscopic hematuria.
    is anyone else having these problems or have a solution with any other diagnosis that will pass?

  2. #2
    Default
    I'm assuming this is a DOS prior to 10/1/16? This dx is no longer a valid code as of 10/1/16 as the range has been expanded. My thought was the system may have been set up with the wrong end date (system not taking DOS into consideration)

    Eff DOS 10/1/16 the new codes are

    R31.21 Asymptomatic microscopic hematuria
    R31.29 Other microscopic hematuria
    CPC-P-A (11/2016), COC-A (9/2016), CPC-A (11/2015), PAHM (2010)
    Fee Schedule Configuration Specialist - Remote

    15 years health insurance experience: Audit, Claims, Customer Service, Payment Policy, Provider Relations, and Reimbursement

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