0

New ICD 10 code changes

sfoster 1 jaar geleden in ICD-10/DSM5 bijgewerkt 11 maand geleden 16

Hello, I just had a couple of claims reject for what appears to be code updates or subdivisions of the code;

F43.8.

  • F43.8, "Other reactions to severe stress," is being subdivided into two new codes — one to capture prolonged grief disorder (F43.81) and another to capture the rest of what was otherwise reported under F43.8 (F43.89, “Other reactions to severe stress”).

Has anyone else run into this one?

Thanks, Sara

+1

We have as well. 

We sent a ticket asking Procentive to add the new ICD 10 codes.

Hey Tanya, Have you gotten a response from Procentive regarding this or any other dx updates that took effect 10/1/22?

Thanks, Sara

Hey Sara,

They responded to our ticket stating that we can manually ad the New Dx to Procentive, them to the clients account and bill it, but that did not work.

I guess they are working on getting the 2023 DX codes entered.

Still waiting,

Hi Tanya, 

I just got a tix from Procentive and the above dx has now been added. ;)

Woot Woot! Thank you for the update!

Awesome! Thank you!!

I'll check my tickets.

+1

We manually added it to our system and then added it to the client accounts. We have not submitted billing yet - releasing those service lines today - but will comment here once we have done so. Thank you for this post - saved me a ton of trouble down the road.

Hello All,


We are happy to announce that all 2023 ICD-10-CM Codes are now active within Procentive!

If you need to use any of the new codes and do not see them populating in the Diagnosis list, you can add them to your Diagnosis Module. Here is a helpful article that will walk you through it.

For reference, here is a list of the new codes and revisions.

I have a question needing help. I am needing to add new billing/documentation codes within the available list. I can't seem to figure out how to go about this. Do I need special access rights or privileges in my Procentive profile? The available codes list including inactive codes doesn't bring up the missing codes I need e.g. the code #90882. 

Hello Amal,

We recommend first looking through our Knowledge Hub as it offers a variety of resources on how to do many of the basic tasks within Procentive: https://support.procentive.com/hc/en-us


If you are unable to find an article on how to achieve this, you can submit a ticket to Procentive and our care team can further assist in providing the best steps to get a new code added depending on your current setup.

Best regards,

Holly Byrnes

Customer Care Leader


Good morning! Has anyone billing either NGS or a NGS Advantage plan been paid with the diagnosis of F43.8, prior to 10/1/22  and  F43.89 after 10/1/22? BCBS is denying stating diagnosis not covered. Arhhhhh!

We have claims that were denied by MN Medical Assistance for the F43.81 diagnosis after 10/1/22. I just spoke to MN DHS yesterday and I was told that is not a valid diagnosis but F43.89 is valid.  

I just had this issue yesterday with a BCBS MN-Medicare Advantage plan.  The F43.89 was billed and they are telling me that its not covered under the client's policy.  But BCBS MN has been paying this diagnosis code for other regular BCBS MN policies.  I was told that we have to submit the correct diagnosis code or send in an appeal.     This is the first issue that we have seen though with the new diagnosis codes.

Yes, this is exactly what I've been told and seen as far as regular BCBS and others paying just fine. So frustrating, I don't understand. 

Did you decide to appeal? And if so, did you have any luck?

That's strange, since it was just sub-divided into those 2 dx (F43.81 and F43.89) effective 10/1/22. We've been reimbursed by BCBS, BCBS pmap, Ucare, PO using the F43.81. It doesn't appear as though we've billed straight MA with, by chance. 🤔