Box 21 on the 1500 form

Day-to-Day Users
21

fsgl wrote on Thursday, October 22, 2015:

I can think of 2 ways to have persisting ICD9:

  1. 08/05 format in Globals, not 02/12.
  2. if Globals is set to 02/12, then user is still justifying with ICD9, which is not the case depicted in justifyme.png.

The script, that governs the printing of CMS-1500, 02/12, does not dictate which set of diagnosis codes to use. It is at the discretion of the user. Note that Patch 4 only changed the number of characters on Line 123 as an accommodation for the longer ICD10 codes. It did nothing else in gen_1500_02_12.inc.php. See attached.

Would suggest that you check the format setting in Globals again & watch Demi as she is in the process of justifying. Sometimes errors are introduced earlier in the process, but the screenshot may not give the whole picture.

If the 10/6 claim went out with ICD-9’s; the clearinghouse will automatically reject it & it will not be processed. Of course ICD Ind. will read 9, not zero; as it should be.

If you are using a clearinghouse, what is the situation with the 837P’s? Are you having a problem with the e-claims as well? Unless you’re dealing with Workers Compensation claims, not a lot of reason to send paper.

We’ll get to the bottom of this; even if it kills us.

22

fsgl wrote on Tuesday, October 27, 2015:

We received the EOB of our first claim with ICD-10 codes today. Claim processed & paid correctly.

The anomalous appearance of ICD-10 codes in Batch Payments is only a cosmetic problem. Fixing it will have no bearing on billing or reimbursement.

We’ve not seen ICD-10 appearing elsewhere where it’s inappropriate.

23

fsgl wrote on Tuesday, October 27, 2015:

If anyone is bothered by the red herring, he can change the column from “Service Code” to simply “Code” mirroring Billing View of Past Encounters & Documents.

24

juggernautsei wrote on Friday, November 06, 2015:

  1. if Globals is set to 02/12, then user is still justifying with ICD9
    She is not justifying with ICD9 but with ICD10 so the system should be set to 8/05? Right?
25

fsgl wrote on Friday, November 06, 2015:

No, set Globals to 02-12 & be absolutely certain that only ICD-10 codes are used.

Would suggest that ICD-10 be made default, as we’ve discussed here.

If the choice is limited only to CPT & ICD-10 as default, difficult for me to visualize a scenario which would mess up billing with ICD-9 codes.