Medicare

If there are more than four diagnosis codes per claim, where can the additional codes be entered on the claim form? We bill electronically.

re: MEDICARE

Are you using 5010 transaction set

re: MEDICARE

5010 allows providers to enter up to a maximum of 12 diagnosis codes. Even though you can report up to 12 diagnosis codes, you can only point or link four of those codes to a particular service at the line level.

re: MEDICARE

Yes, our system is 5010 compliant..I did ask the software vendor where can I enter the additional codes and I was told only four allowed..(?)

re: MEDICARE

•your electronic claims (837P)-- Providers will need to work with their software vendors to ensure they have the capability of sending 12 diagnosis codes per claim and that they have the functionality in place to allow for the service lines to point to the new codes, taking into consideration the 2-byte values. payers will have to accept the full suite of 12 diagnosis codes when they implement 5010. The diagnosis field has been formatted to contain a check digit that will identify whether the code that follows is ICD-9 or ICD-10 as there will be a period where claims submitted may contain either depending on the date of service prior to or after 10/01/2014.

re: MEDICARE

Thank you for the informations.