Forum - Questions & Answers
Diagnosis code
Pt came in & doc diagnosed her with refracted eye error(dx code 367.9). BCBS denied the claim stating its not a payable code. Pt also complains of headache, but was not reported. Do you think I could rebill the claim with a headache with no problem? Thanks!
re: Diagnosis code
Payers are increasingly denying claims that are billed with unspecified codes. This code is unspecified. You will likely need to come up with a more specific code to get the service covered. Payers often take the position that if a provider is treating the problem, they generally know more details than a generic code. I have been noticing this trend for at least 2 years.