ICD-10 Update
Complaint:
I am
having a problem with two different software companies that offer scrubbers to
assist with submitting claims. (One of the two we are paying yearly to use)
Neither one of these companies catch excludes 1 codes in their edits because
they are stating the two codes can be used together. I have explained to them
and given examples to no avail. Ex: D64 has excludes 1 (at the beginning of the
section) for code (C92.0_ ). These two codes should not be billed together.
They are insisting that D64.81 and C92.00 can be billed together. Any
suggestions other that dropping both of them.
Numerous complaints re
coming to our office on a daily basis.
As indicated on several
articles I have posted, the current mapping or GEM tools to convert ICD-9 to
ICD-10 is not accurate and/or not converting correctly. All EHRs or billing software are indicating
an ICD-10, however, it is up to the physician or billers to determine if the
ICD-10 indicated is correct. As stated
in the complaint above must EHRs or billing software DO NOT take consideration
to:
·
Excludes1
·
Excludes 2
·
Inclusion
Physician and coders
are responsible for :
·
Appropriate
Coding
·
Coding to
the correct and highest level of specificity
·
Clinical
Documentation
Avoid upcoding ,
and the use of unspecified.
For more
information, please call us.
FOR MORE INFORMATION PLEASE CONTACT:
HPP Management Group, Corp.
Developers of the AccuChecker Product Line
Phone: (305) 227-2383 or 1-877-938-9311
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