Medicare Compliance & Reimbursement

After  Donelle Holle  reported that she was seeing instances of Z23 (Encounter for immunization) being denied in error, Eli investigated further and discovered that NGS Medicare announced on Oct. 21 that it had “identified a claims processing issue” that impacted reimbursement for this diagnosis code.

“Claims for the following immunization and administration procedure codes incorrectly denied due to an incorrect diagnosis code,” NGS said in an Oct. 21 email blast to providers. The list of codes is as follows: G0008, G0010, G0009, 90630, 90669, 90670, 90686, 90732, 90739, 90740, 90743, 90744, 90746, and 90747.

The system error “impacted providers who submitted claims for these services in which they reported ICD-10-CM diagnosis code Z23,” NGS said. “A mass adjustment will be made to claims that were denied in error; adjustments will be completed soon. It is unnecessary to resubmit the claim or to request an appeal. No provider action is needed.”