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Denial for V22.2 code

  1. Default Denial for V22.2 code
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    In the past when a patient transfers care I've billed with a V22.2 and have been paid by all insurances. Recently I've been denied by Blue Shield for this code. They state the reason for the denial is because we need to use a principal diagnosis not a supplementary diagnosis. My interpretation is that they don't like the V code. The patients were not seen for any complications during these visits so no other diagnosis can be used.

    Has anyone else had this problem recently or this year? None of the CSR can help me at BS supposedly so not sure what else I can do. Any suggestions would be appreciated.

  2. #2
    If these Patients are coming in for Routine OB Visits Antepartem,
    then they should be used with either V22.0 or V22.1.

    V22.2 is very Specific to Pregnancy Incidental
    And can not be used as a Primary DX code

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