Avoiding D9 Denials

March 26th, 2018 - Nicole, QCC
Categories:   Billing   Claims   Denials & Denial Management  
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The following is according to WPS.

Please make sure what is bold below is entered verbatim on the second line of the "Remarks" section. This should be the only thing on the second line of remarks:

  • Patient control nbr - If you are changing or adding a patient control number
  • Admission hour - If you are changing or adding the admission hour
  • Admission type - If you are changing or adding the admission type
  • Admission source - If you are changing or adding the admission source
  • Medical record number - If you are changing or adding the medical record number
  • Condition code - If you are changing or adding a condition code
  • Occ codes - If you are changing or adding an occurrence code
  • Occ span codes - If you are changing or adding an occurrence span code (For example, you are adding a 3 day qualifying hospital stay)
  • Value codes - If you are changing or adding a value code
  • Modifier - If you are changing or adding a modifier
  • Date of service - If you are changing a date of service on a line or changing the statement from and to dates, use a D0
  • Units - If you are changing units
  • Conditional pa - This should only be used if the original claim has rejected with a MSP reason code and a conditional payment is being requested
  • Recalculation - If you want your claim recalculated for a different payment
  • IME payment - If you are adjusting your claim for an Indirect Medical Education (IME) payment
  • Multiple changes - Please enter your changes. Example: If you are changing a modifier and a unit
  • DX code - If you are changing a diagnosis code on an outpatient claim, inpatient claims would use a D4
  • POA - If you are changing, adding, or removing a Present on Admission (POA) indicator, unless you are changing an N to a Y and/or if it affects reimbursement then you would use a D4
  • Removed non - If you are removing non-covered charges
  • Other - These claims will suspend to a file location if the remark is not valid

Choosing a remark listed above will prevent the claim being returned back to you.


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