Medicare claim - too many diagnosis codes error
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Medicare claim - too many diagnosis codes error
We have a Medicare claim with six diagnosis codes. When I run the claim check in RM, the claim is generating "Too many diagnostic codes" error and it is flagged red.
Anyone else see this behavior? Is there somewhere else I need to indicate that I am using more than 4 diagnosis codes to get past this?
- Gavin Walker
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Re: Medicare claim - too many diagnosis codes error
Walker Tek Solutions, LLC
417-890-6777 x0
fax: 417-763-6386
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Re: Medicare claim - too many diagnosis codes error
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Re: Medicare claim - too many diagnosis codes error
How can we retain the 12 diagnosis and prevent 12 diagnosis pointers to be sent out? By default in transaction it checks off all. To manually uncheck 8 is too much work. Can we suppress the checked pointers if over 4 at the medisoft level?
Any other way to deal with issue. Interestingly we didn't have any issue with the older platform on the same clearing house. Thanks
Medisoft V22.0.2.35 Networking
Revenue Management 3.1914.16116.394
OS Main: WIN10Pro
OS Clients Win10
- Gavin Walker
- Posts: 4626
- Joined: Wed Apr 04, 2007 10:11 pm
- Location: Springfield, MO
- Contact:
Re: Medicare claim - too many diagnosis codes error
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- Posts: 16
- Joined: Sat Oct 17, 2015 9:49 pm
Re: Medicare claim - too many diagnosis codes error
Gavin first of all thanks for responding. I believe in their old platform they were either letting all pointers pass through or they had someway of suppressing everything after the first four. Unfortunately the new one doesn't let that happen. So they are asking them to be suppressed from the medisoft generated output file and I don't know how to short of manually deselecting 8 of those from each transaction line and that is lot of clicking. Medisoft by default checks as many pointers as you have diagnosis listed. Don't know if there is anyway to stop this default behavior. Of course I can switch to only 4 diagnosis as in the past and that beats the purpose of achieving more specificity on claims and listing all comorbid conditions.Gavin Walker wrote:The ANSI 5010 standard only supports up to 4 diagnosis pointers on any given charge line even though there can be 12 diagnosis codes on a claim. Your previous clearinghouse must have been only checking the first 4 when the claims were submitted to the payers. Now they are flagging this as an error because it is probably incorrect to assume which 4 are intended to go with any charge line and that can affect the payment.
Any suggestions are appreciated. Thanks again.
Medisoft V22.0.2.35 Networking
Revenue Management 3.1914.16116.394
OS Main: WIN10Pro
OS Clients Win10
- Gavin Walker
- Posts: 4626
- Joined: Wed Apr 04, 2007 10:11 pm
- Location: Springfield, MO
- Contact: