N89 (Other inflammatory disorders of the vagina) has an Excludes 1 note below the category for R87.62X (abnormal results from vaginal cytological exam), D07.2 (vaginal intraepithelial neoplasia), R87.623 (HGSIL of vagina), N76.XX inflammation of the vagina), N95.2 (senile vaginitis), A59.00 (trichomonal leukorrhea)įinally, if you believe an Excludes1 note denial is incorrect, please consult the ICD-10-CM codebook to verify appropriate use of the billed codes and provide supporting documentation through the normal dispute process as to why the billed diagnoses codes are appropriately used together.Find vetted therapists who are in-network with Anthem Blue CrossĪnthem Blue Cross is one of the largest health insurance companies in California and provides medical and behavioral health benefits to millions of residents.J03.- (Acute tonsillitis) has an Excludes 1 note below it which includes J02.- (acute sore throat), J35.1 (hypertrophy of tonsils), J36 (Peritonsillar abscess).
#Blue cross anthem california code#
Examples of this code scenario would include but are not limited to the following: In ICD-10-CM, when a category includes an Excludes 1 note, it outlines what codes should NOT be billed together. If the Excludes 1 note appears beneath a specific code (3, 4, 5, 6 or 7 characters in length) then it applies only to that specific code.
#Blue cross anthem california series#
These notes appear below the affected codes – if the note appears under the Category (first three characters of a code), it applies to the entire series of codes within that category. An Excludes 1 note indicates that the excluded code identified in the note should not be billed with the code or code range listed above the Excludes 1 note. One of the unique attributes of the ICD-10 code set and coding conventions is the concept of Excludes 1 notes. For example, if there is an indication at the Category level that a code can be billed with another range of codes, it is imperative to look for Excludes 1 notes that may prohibit billing a specific code combination.įor assistance in determining proper coding guidance, the following site should be helpful: Please remember to code to the highest level of specificity. To help ensure the accurate processing of claims, use ICD-10-CM Coding Guidelines when selecting the most appropriate diagnosis for member encounters.
0 kommentar(er)
