When diagnosis codes change, suppliers are likely to experience an increase in rejected claims. If you are a respiratory supplier for example, CMS deleted a common ICD-10 code: I27.2 (Other secondary pulmonary hypertension). As a result, every order with this diagnosis and a service date after October 1 will reject until your staff intervenes. Staff must replace diagnosis I27.2 with one of the new, more specific codes: I27.20-I27.29 or I27.83.
To avoid delays caused by rejections, suppliers should proactively address outdated diagnoses. Run a report from your billing software that exports active and recurring orders to include linked diagnosis codes. Then, query a match to deleted codes and update affected orders and patient accounts with the most appropriate new code. Suppliers are permitted to modify diagnoses for billing purposes, without securing physician approval, as long as the underlying diagnosis is supported in the medical records.
To review the complete list of added, revised, and deleted ICD-10 codes, suppliers can go to the CMS 2018 ICD-10 CM and GEMs webpage and download the 2018 Code Descriptions in Tabular Order file. This file will contain multiple documents. The “icd10cm_codes_addenda_2018” is a useful file that shows all additions, deletions, and revisions in alphabetical order by diagnosis code.
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