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Has anyone in the chemical dependency/substance abuse field had issues with the dx code Z13.89 not being paid by insurance companies?

mooremisc 4 years ago in ICD-10/DSM5 updated 4 years ago 8

I have tried to bill Blue Cross Blue Shield, Sanford Health, and UBH/Medica using the dx Z13.89 and the claims are being rejecting, saying the dx is too vague.

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Yes we have had issues using that code as well. They give different reasons for rejecting it but the end result is the same. I have looked for a different code that fits better and can't really find one. I'm curious to see what others have done on this issue.

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Z13.89 The code is really a very broad code for various screenings it is not really used as a diagnosis code but more of a procedure code so it depends on what you are trying to bill for. this code can be used for Alcohol, depression , gout , obesity screening etc. So if you are billing for a screening procedure it should normalaly work

If you are trying to bill for treating say Alcohol abuse you would need a F10.xx type code which is a diagnosis not a procedure

We use this dx code when we screen a client for alcohol/drug abuse, but they do not warrant a dx. This code is the equivalent to the ICD-9 V79.1 code.

Does anyone have a ICD-10 code that has been paid on for Screening of alcoholism?


R69 deferred diagnosis? We have been paid for that...

When I do a search for R69 dx code it doesn't show up...Do I need Procentive to add it?

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This Dx code will need to be added to your master list in the Diagnosis Module. This can be added by any staff (with permission) in the Diagnosis module, Add window.

Please open the add window, select type ICD 10. Type the ICD 10 code in the code text field. The code appears in the "ICD 10 Reference" below the code entered, indicating that it is available to add. Type in the name of the diagnosis and save.