Wiki Diagnosis B02.9 - Invalid Code?

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lorettac

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Miramar, FL
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Hello, need help on Diagnosis Clarification please!
Female patient, age 63, had an office visit on 03/15/2017 and provider diagnosed with Zoster without complications. Submitted claim with primary diagnosis B02.9 with E&M 99213 to Florida Blue but rejected due to Diagnosis code is not a valid code for DOS. I researched this code which is still active and no special guideline. Called Florida Blue and spoke with representative who stated that there is no further information just this code is not valid on the DOS.
Please, if anyone could help to explain how to resolve this coding issue. Thank you very much and appreciated! :(
 
Hmmmmm

If the documentation says that the patient had zoster with no complications, then it sounds to me like whomever was reviewing this at the insurance company made a mistake and I would ask my billing department to resubmit, possibly with documentation attached whether it is requested or not. Sorry I'm not more help!
 
trinity9058 said:
If the documentation says that the patient had zoster with no complications, then it sounds to me like whomever was reviewing this at the insurance company made a mistake and I would ask my billing department to resubmit, possibly with documentation attached whether it is requested or not. Sorry I'm not more help!
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Thanks trinity9058, for your advise, it's great help! :eek:
 
I wonder if the payer is seeing the .9 and automatically denying as unspecified. Usually it does mean unspecific but now always.
 
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