Hi,
I am still on 2.7.3. If this problem is already fixed in the later versions, please
ignore this.
I have a peculiar problem with the icd9 ordering on the hcfa form.
We have the following justified codes: 99394(V20.2), 99173(V72.0) , 90732 52(V03.89).
The diagnoses in Box 21 always comes out as 1)V03.89 2)V20.2 3)V72.0, no matter how we order
them while entering encounters. FreeB seems to be sorting the diagnoses set.
As per the Insurance co, the ordering in Box 21 has a priority the most important being 1).
Now, since V03.89 appears as our most important diagnosis, the smart Ins co. just pays for
shot administration and totally discounted the V20.2 physical exam part, the fee for which is a lot
higher …
We tried all combinations of entering the above. Does anyone know what’s going on before I
get all dirty with perl
Thanks,
baluRaman
This particular problem has not been fixed in later version. It is due to the fact that FreeB used a “smart function” that will rearrange the order for whatever it sees fit. But from my experience, the ICD9 code that has multiple justification reference will have highest priority (first in the order). For example, in your case, if you do 99394 (V20.2), 99173 (V20.2)(V72.0), 90732 52(V03.89), then the ICD9 code will be in the order 1)V20.2 2)V72.0 3) V03.89, because V20.2 has 2 references, therefore it will become #1. That’s how it works!!!
Correct me if I am wrong. From what I know, the insurance company should pay you for the CPT codes not the ICD9’s. And the Modifier 52 that you use, is it correct? should it be 25? Modifier 52 is for reporting reduced services without disturbing the identification of the basic service. Modifier 25 is for separate E/M. You should call the insurance company for clarification.
