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Foreign body codes.

Takle Posted Tue 29th of October, 2019 17:35:37 PM
We submitted a claim with cpt 92002 with ICD 10 code of T15.02XA. This claim was paid by BCBS. The patient had 2 follow up visits, that the Dr. codes out 92012 with diagnosis of T15.02xS and both visits have been denied for Claim/services lacks information or has submission/billing error(s). Can you help me understand about filing for foreign bodies and what I need to do the get these follow up visits paid. Thank you.
SuperCoder Answered Wed 30th of October, 2019 06:51:05 AM

Hi Takle,

 

Thanks for your question.

 

It seems that insurance requires some information or there is some submission/billing error. Please provide us Remarks Code or MOA code, which insurance must have provided to you to identify the missing/invalid information. Seeing that we may provide you the exact resolution to this problem.

 

Thanks

Takle Posted Wed 30th of October, 2019 11:24:19 AM
The remark code was CO-16 and MA63 Claim/service lacks information or has submission/billing errors and Missing/incomplete/ invalid principal diagnosis. Thank you.
SuperCoder Answered Thu 31st of October, 2019 09:14:45 AM

Thanks for providing required information. Here is the answer:

 

This remark/MOA code shows that principle diagnosis code (T15.02XS) is invalid and you should submit a valid code.

 

Please note that ICD-10 code T15.02XS (…sequela) is not a supported dx code. So, we suggest you to choose a code from following ICD-10 codes (if present in documentation):

  1. T15.02XA (Foreign body in cornea, left eye, initial encounter)
  2. Z01.00 (Encounter for examination of eyes and vision without abnormal findings)
  3. Z01.01 (Encounter for examination of eyes and vision with abnormal findings) as primary diagnosis or any other supported Dx code from medical record.

 

As per ICD-10 CM official guidelines, do not use a late effect external cause code for subsequent visits for follow-up care of the injury when no late effect of the injury has been documented.

 

Please feel free to write if you have any question.

 

Thanks

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