Rank: New Member
Joined: 4/16/2015(UTC) Posts: 9
Thanks: 3 times
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Hello,
I have a claim from last year prior to the code change in October that was submitted to United Healthcare several time. The patient is in a full time splint. I used the following ICD-9 diagnosis code:
350.2 524.52 524.62
CPT code :
E1399
This claim has been rejected due to the following reason:
"Before we can process this claim, we need information that was missing, invalid or unreadable"
ICD-9 Diagnosis code(s) including the 4th and 5th digit if applicable.
I have no idea what they are requesting. Please Help.
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Rank: Administration
Joined: 11/21/2012(UTC) Posts: 1,611
Thanks: 39 times Was thanked: 51 time(s) in 51 post(s)
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Hi shemen9!
Hm, very interesting, i don't see an issue with the ICD-9 codes you used! They are all specific diagnosis codes that do not require additional digits.
350.2 - Atypical face pain 524.52 - Limited mandibular range of motion 524.62 - Arthralgia of temporomandibular joint
The only i thing i can think of beyond that - you may want to double check the "ICD indicator" field located in the upper right hand corner of box #21 on the claim form and confirm that there is a "9" there (standing for ICD-9) and not a "0" (standing for ICD-10). Let me know if that is not the case and we can explore it further.
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Rank: New Member
Joined: 4/16/2015(UTC) Posts: 9
Thanks: 3 times
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I did check box #21 on the claim. It does have a 9. I am at a loss as to what they could possible want.
Thank you for all your help.
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Rank: Administration
Joined: 11/21/2012(UTC) Posts: 1,611
Thanks: 39 times Was thanked: 51 time(s) in 51 post(s)
|
Hi shemen9!
No problem! Hmmm, it could have been a simple processing error on the insurer's end.
One thing you could try is using only 524.52 - Limited mandibular range of motion & 524.62 - Arthralgia of temporomandibular joint on the claim and drop the 350.2. 350.2 does not have an additional digit to add, but it seems their system is looking for one for some reason.
Was the ICD-9 remark the only remark code listed? Perhaps they were referring to other information that was " missing, invalid or unreadable"?
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Rank: New Member
Joined: 4/16/2015(UTC) Posts: 9
Thanks: 3 times
|
Thanks for the unending help that you provide.
Yes, the ICD-9 remark was the only remark listed.
I will see what happens after taking your advice.
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