Wiki Non Payment on Office Visits fron Blue Cross Merced

[gherimicheleCPC]

I am in California and in the month of December one Blue Cross Plan started denying only the office visits with codes MA63 Missing/incomplete / invalid principle diagnosis and 16 Claim/service lacks information which is needed for adjudication.
All services preformed with the OV were paid except the OV. No other insurances including MCAR are denying these claims. I am puzzled is anyone else having this issue ?

 

[csperoni]

I'm not in CA, but what ICD10 code is denying? Was it a code that was changed 10/01/2018 and is now truncated or deleted?

 

[clg23]

non payment on office visits from Blue Cross Merced

i would look at my ICD.10 book to see if the dx is valid. You did not mention what other charges were being billed on the same day but if it was with a procedure code on same day the visit will be denied without the appropriate modifier.

i hope this helps.