When I create a claim to send to the clearinghouse if the date of service is on or after 10/1/15 the ICD Indicator has to read [0]. If it is before 10/1/15 it has to read [9]. This is pulled to box 21 on the 1500 form to the far upper right noted by ICD Ind. [ ]. When I am creating claims on or after the 10/1/15 DOS it is still pulling the [9].
How do we fix this?
I changed the form setting to 2.12 but it did not fix the issue.
Thank you!
My messages are getting lost in the ether.
Thanks for the tip and I have applied the patch now and we have another delima.
Demi is seeing that the ICD10 codes are pulling to the payment page. When she is posting the insurance payment, they pay on the CPT code not the icd10 code, but both sets of codes are there. The icd codes hold no actual dollar value and should not be on the batch posting screen.
I need to edit my prior post to say that Patch 4 increased the number of characters from 7 for ICD-9 to 8 for ICD-10.
Patch 4 does not include any new script to distinquish which ICD’s to use according to dates of service. Demi must remember to use ICD-9 for DOS before 10/1/15 & ICD-10 after 10/1/15.
I’m surprised that you were paid at all. Clearinghouses generally reject claims with the wrong set of diagnosis codes.
Don’t understand how diagnosis codes appeared in Batch Payments after patching to 4.
I am just now getting back to this and the way we get paid is that the claim is rejected then she corrects the issue and then resubmits. It would be nice to have a clean submit the first time.
Here is a screenshot of what Demi is seeing in the patients chart when she is trying to post a payment.
The only way that I can think of creating the situation depicted in servicecodeissue.png would be have the ICD-10 codes under CPT all mixed in together & the billing clerk searched for both diagnosis codes & service codes under CPT. See attached.
If I remember correctly, Batch Payments displays only the code without the prefix of CPT in our production copy, so it’s a bit of a mystery why the code type appears before each code in the Service Code column.
Try checking the Fee Sheets of the rejected claims to see how the errors were generated & codes table for any mixing of codes.
Speaking of mix-ups, this may have been overlooked.
Thanks!
There is always a cause to be polite. It never hurts to be kind.
I appreciate all the digging you are doing. I don’t know billing at all so this is helping me as well as the hundreds of people reading this post.
No need to thank me because everything in my prior post with the exception of the last sentence is wrong.
I just checked old Batch Payments in production copy & the service codes were preceded with CPT4. With claims after 10/1/15, ICD-10 codes did appear as in your first attachment. Just checked in 4.2.0 Demo, same situation. See attachments.
We appear to have a bug.
Our first claim with ICD-10 codes was sent on 10/3/15, so that EOB has yet to arrive, but it was paid according to the insurer’s Claim Status.
If the CMS-1500 is correct, there is no reason to reject the claim despite the bug in Batch Payments. What was the denial reason on the EOB for that 10/6/15 claim? Something else, not Batch Payments, is causing the rejection.
Don’t understand why the second group of ICD-10’s is described as “Procedure/Service” when in clinical practice we don’t use ICD’s for coding the type of service. See attachment a.
Is it possible that this is the reason ICD-10 codes are showing up in Batch Payments? See b & c.