UB04 ICD10 issues

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Dsnooky
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Joined: Tue Mar 25, 2014 12:23 pm

UB04 ICD10 issues

Post by Dsnooky » Mon Oct 12, 2015 5:27 pm

Good afternoon
I had several claims deny from our clearinghouse that were submitted with ICD10.
According to the clearinghouse we have an indicator of PR which equals ICD9 and it should be APR indicator for ICD10.
What are we doing wrong?
Thank you

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Gavin Walker
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Re: UB04 ICD10 issues

Post by Gavin Walker » Tue Oct 13, 2015 9:11 pm

Probably the iGuide is not set properly in Revenue Management or the ICD-10 cut-over date is not set on the insurance.
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Dsnooky
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Re: UB04 ICD10 issues

Post by Dsnooky » Wed Oct 14, 2015 10:15 am

The iGuide is set at "outbound claims (837P MS19 5010..." and I checked the ICD10 date on the carriers and it is set to 10-1-15, "Diagnosis Code set is listed as ICD-10 and ICD-10 Effective Date is set at 10-1-15" Is my iGuide right?

Dsnooky
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Re: UB04 ICD10 issues

Post by Dsnooky » Wed Oct 14, 2015 11:36 am

I found out from my clearinghouse that it is only showing this for FL70 which is patient reason DX. I don't understand. I even tried to change the iGuide to 837I to see if that would work.

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Gavin Walker
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Re: UB04 ICD10 issues

Post by Gavin Walker » Wed Oct 14, 2015 3:47 pm

Except you say these are UB04 claims so the correct iGuide would start with "837I MS19 5010 Claims". Probably start with General UB04 if you are unsure which one to use. Are you using some sort of middle-ware to convert the 837P claims to 837I? Are you filling out the UB04 smart screens?

Dsnooky
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Re: UB04 ICD10 issues

Post by Dsnooky » Wed Oct 14, 2015 3:54 pm

No middle ware and yes I can see the smart screen; not sure what you mean by "filling out" the UB04 smart screen. I have always had the smart screen downloaded and set up for the UB's.

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Gavin Walker
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Re: UB04 ICD10 issues

Post by Gavin Walker » Wed Oct 14, 2015 3:58 pm

FL 70 is on the smart screen. Did you fill it out with an ICD-10 code?

Dsnooky
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Re: UB04 ICD10 issues

Post by Dsnooky » Thu Oct 15, 2015 9:59 am

that's what I am missing, I was not using the smart screen for that. Thank you, I appreciate your help. :D

kidspeds
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Re: UB04 ICD10 issues

Post by kidspeds » Tue Nov 10, 2015 11:06 am

Hello
I am trying to resend old claims with ICD 9 for well visit
When I check on the Raw text .. It shows BK V20.2 for well visit
But shows BF Z23 for vaccines causing rejections
Any advice?
Thanks

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Gavin Walker
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Re: UB04 ICD10 issues

Post by Gavin Walker » Tue Nov 10, 2015 3:01 pm

Z23 is an ICD-10 code, but BF indicates a secondary ICD-9 code. What do you have entered in the ICD-9 Code field of the diagnosis that you entered?

kidspeds
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Re: UB04 ICD10 issues

Post by kidspeds » Sat Nov 14, 2015 11:23 am

Good morning
It was all ICD 9 codes
Some of the still going as ICD 10
Thanks

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Gavin Walker
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Re: UB04 ICD10 issues

Post by Gavin Walker » Mon Nov 16, 2015 5:04 pm

What do you have for the following in Medisoft?
Date Through in Transaction Entry:
ICD-10 Cut-over date on the Insurance record:
Diagnosis code typed in Transaction Entry:
ICD-9 Code from the diagnosis code you entered:
ICD-10 code from the diagnosis code you entered:

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