ICD-10 Carrier Problems and Resolutions
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ICD-10 Carrier Problems and ResolutionsThis spreadsheet is maintained by PCC, the Physician's Computer Company. For more information, visit www.pcc.com.
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DateState/RegionPayersProblem DescriptionSolutions or Status
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10/5/2015TennesseeBCBS of TNDenying 96127 and 96110 when billed with Z13.89Code Z00.121 or Z00.129
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10/5/2015TennesseeBCBS of TNClassifying 96110 when billed with Z13.4 as a "non-covered preventive benefit". 100% patient responsibility.Code Z00.121 or Z00.129
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10/5/2015MarylandCarefirstInternal errors by carrierResubmit
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10/3/2015Washington StateAvailityExternal Cause code (W57.XXXA) may not be primaryRecode and resubmit
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10/5/2015PennsylvaniaBCBS "239.48" "Incomplete"?
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10/7/2015TexasAllNoneJust added as reassurance. All seems to be processing and adjudicating as before.
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10/8/2015MassachusettsMassHealthNone!10/1 services are showing online as "scheduled to pay"
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10/8/2015GeorgiaMedicaidDenying all Unspecifieds no matter how appropriate.
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10/13/2015VermontMedicaidDenying multiple administration codes as duplicates for using Z23.Update 10/29/15: Billing 90460/90461 just once with the total amount of units per the vaccines administered during the visit. We are now being paid correctly. (Orig 10/8/15: None yet. Cannot reach a person.)
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10/20/2015TexasHumanaWe received our first denials today from Humana for diagnosis code: B97.89 (viral syndrome).Looks like it can be used as a 2nd diagnosis, but not as a single diagnosis, in order to get paid.
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10/22/2015Washington StateCommunity Health PlanAll Zcodes being denied due to a bug in their system.They will auto reprocess once solved.
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10/13/2015New YorkAetna, Oxford, BluesNoneJust confirming all are being paid w/o incident.
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10/21/2015New JerseyHorizon NJ Health(Z00.121 and Z00.129), hearing (Z01.10), vision (Z01.00) and vaccines (Z23) with denial code* I10*: *"Diagnosis code can not be the primary diagnosis"Known internal error. They will auto reprocess once solved.
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10/9/2015So CABlue shield/Aetna/Cignano rejections; paid on ill visits and PE w/vaccineJust confirming all are being paid w/o incident.
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10/21/2015New JerseyHorizon NJ HealthDenying 96110 when submitted w/9939X and z13.4 stating "cannot submit medical and mental health on one claim". Requiring Z00.12X for screenings
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2015