Forum - Questions & Answers

Mar 15th, 2016 - afgbilling 59 

Medicare ICD 10 denial

Our practice only has a couple of Medicare patients so I need some help as this isn't something I see on a daily basis. We saw a patient and the Dr used E03.8 (other specified Hypothyroidism) as the DX code. Medicare denied stating we are required to code to the highest level of specificity. I have read articles that states Medicare allows "other" and "unspecified" codes so I'm not sure why this denied. Can anybody help me out on this one? Thank you so much :)

Mar 15th, 2016 - KIMESPINOSA 2 

re: Medicare ICD 10 denial

They do, but unspecified and other specified are two different things. If you are coding "other specified" you need a additional code to "specify".

If you are coding unspecified as you do not know the cause or type need to use E03.9.

Mar 15th, 2016 - afgbilling 59 

re: Medicare ICD 10 denial

OK, that makes sense. Thank you very much!

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