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
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.
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):
- T15.02XA (Foreign body in cornea, left eye, initial encounter)
- Z01.00 (Encounter for examination of eyes and vision without abnormal findings)
- 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.