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shemen9
#1 Posted : Wednesday, March 9, 2016 4:45:20 PM(UTC)
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shemen9

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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.
courtneydsnow
#2 Posted : Wednesday, March 9, 2016 5:41:49 PM(UTC)
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courtneydsnow

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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.
shemen9
#3 Posted : Thursday, March 10, 2016 12:27:46 PM(UTC)
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shemen9

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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.
courtneydsnow
#4 Posted : Thursday, March 10, 2016 12:49:48 PM(UTC)
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courtneydsnow

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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"?
shemen9
#5 Posted : Wednesday, March 16, 2016 3:39:09 PM(UTC)
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shemen9

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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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