CSC 732: "Information submitted inconsistent with billing guidelines." [1] While the T-MSIS data dictionary lists ICD-10 CM PCS the relevant set of procedure codes are referred to as ICD-10 PCS.. ICD-10-PCS Procedure Code and Description (cont.) Valid Procedure codes can be either ER, HC, IV, or WK. When there is more than one iteration of 2300.HI with HI01-1 = "BK" or "ABK" the claim is rejected. A qualifier provides specificity regarding an additional attribute of the procedure, if applicable. Box 24A (Shaded Area) - Valid UPN Qualifier and appropriate Universal Product Number (UPN) This area will have a combination of two values entered: PDF J-Code to National Drug Code - Providers Fax Number: (803) 462-3986. On October 1, 2015 the conversion from the 9th version of the International Classification of Diseases (ICD-9-CM) to version 10 (ICD-10-CM) occurred. Receive 277CA with: Comparing ICD-9-CM and ICD-10-PCS: Extraction . Two codes are assigned for the four vessel coronary artery bypass and an additional code is assigned for excision of the greater saphenous vein. Outpatient procedure codes in the OT file are to be reported in the PROCEDURE-CODE field rather than the HCPCS-RATE field. 1B Blue Shield provider number. 4 What is the code for more than one ICD-10 diagnosis? 631 0 obj <>stream Note: Gateway and Connect access questions cannot be done via email, please call the appropriate phone number for assistance. A Complete Guide to UB-04 Forms for Healthcare Providers code qualifier strength strength strength volume volume name number unit unit strength j0735 ml 1000mcg/10 1000 mcg ml 10 0.1 clonidine hcl/pf j0735 ml 5000mcg/10 5000 mcg ml 10 0.5 clonidine hcl/pf last update: september 18, 2017 page 6 of 45 . If 2300.HI01-1 is "ABK" then 2300.HI01-2 must be a valid ICD-10 Diagnosis code, otherwise claim is rejected. <> CSC 254: "Principal diagnosis code. Washington, D.C. 20201 Prior Authorization Requirement Summaries, Code Lists and - BCBSIL If 2300.HI01-1 is "BBR" then 2300.HI01-2 must be a valid ICD-10 Procedure code, otherwise claim is rejected. information necessary to construct a procedure code. CMS 1500 claim form and UB 04 form- Instruction and Guide endstream endobj startxref %PDF-1.6 % When there is no drug-specific procedure code: -Use an appropriate unlisted code, and -Bill at acquisition cost. Receive 277CA with: 2 0 obj Other Preventive Services. Several types of services on OT claims, such as transportation services, DME, and lab work, are not expected to have diagnosis codes. ChiroCode.com for Chiropractors CMS 1500 Claim Form Code-A-Note - Computer Assisted Coding Codapedia.com - Coding Forum Q&A CPT Codes DRGs & APCs DRG Grouper E/M Guidelines HCPCS Codes HCC Coding, Risk Adjustment ICD-10-CM Diagnosis Codes ICD-10-PCS Procedure Codes Medicare Guidelines NCCI Edits Validator NDC National Drug Codes NPI Look-Up . If 2300.HI01-1 is not equal to "BK" or "ABK", the claim is rejected. New York State Medicaid Update - March 2023 Volume 39 - Number 6 % 172 0 obj <>/Filter/FlateDecode/ID[]/Index[133 79]/Info 132 0 R/Length 154/Prev 200687/Root 134 0 R/Size 212/Type/XRef/W[1 3 1]>>stream Receive 999E with: Fargo, ND 58108-6729, Register for ICD-10 Testing Week: March 3-7, 2014.