Dx Error for Claims in Claims Management with ICD10

Technical problems with Medisoft.
Post Reply
mbpros
Posts: 312
Joined: Fri Mar 11, 2011 6:59 pm

Dx Error for Claims in Claims Management with ICD10

Post by mbpros » Mon Oct 19, 2015 3:21 am

We have found that if claims are created using a valid ICD10 code that these claims will have a status of DxError. Apparently the reason for this is that we have to place an ICD9 code in the ICD9 column on the Diagnosis Code List for each ICD10 code added to the Diagnosis Code List.

So for example, if we add code M99.01 to the Diagnosis Code List and we have M99.01 in the ICD10 column (with a description) but the ICD9 column is blank, then the software returns a DxError since the ICD9 column is blank.. Obviously this makes no sense. We even have the payer set up on the Options and Codes tab to use Diagnosis Code Set ICD10 with an ICD10 Effective Date of 10/1/15.

We are using the proper IGuide...so any idea how to get around this? Makes no sense that we have to continue to input ICd9 codes in the ICD9 column as we add new ICD10 codes.

Steve

User avatar
Gavin Walker
Posts: 4625
Joined: Wed Apr 04, 2007 10:11 pm
Location: Springfield, MO
Contact:

Re: Dx Error for Claims in Claims Management with ICD10

Post by Gavin Walker » Mon Oct 19, 2015 1:19 pm

You need to do Start -> All Apps -> Revenue Management -> Claims Editor Update Client from all computers that run Revenue Management.

Also, make sure the ICD-10 cut-over date is filled out on all insurance.
Gavin Walker
Walker Tek Solutions, LLC
417-890-6777 x0
fax: 417-763-6386

mbpros
Posts: 312
Joined: Fri Mar 11, 2011 6:59 pm

Re: Dx Error for Claims in Claims Management with ICD10

Post by mbpros » Tue Oct 20, 2015 4:31 am

Already have the most current version of Claims Editor and the ICD10 cut over date was filled out....
Steven Zats
Medical Billing Professionals

User avatar
Gavin Walker
Posts: 4625
Joined: Wed Apr 04, 2007 10:11 pm
Location: Springfield, MO
Contact:

Re: Dx Error for Claims in Claims Management with ICD10

Post by Gavin Walker » Tue Oct 20, 2015 3:54 pm

What do you have in Date From and Date To in Transaction Entry?

mbpros
Posts: 312
Joined: Fri Mar 11, 2011 6:59 pm

Re: Dx Error for Claims in Claims Management with ICD10

Post by mbpros » Tue Oct 20, 2015 3:59 pm

They are October dates...fortunately 99.9% of claims are going through...not sure why selected ones in select practices are having trouble.
Steven Zats
Medical Billing Professionals

Andrew
Posts: 153
Joined: Tue Mar 19, 2013 3:24 pm
Location: Springfield, MO
Contact:

Re: Dx Error for Claims in Claims Management with ICD10

Post by Andrew » Tue Oct 20, 2015 4:57 pm

This is a known issue where if the ICD9 is not filled out it will be marked DX error in claims management. You will need to put the ICD9 in to have it stop. You can mark these ready to send and they should send without issue through RM as long as your insurance is set correctly with effective date and ICD10.
Andrew Analla
Support Team
MedTech Medical Management Systems
3058 S Delaware Ave
Springfield, MO 65804
Ph: 417.890.6777 | Fax: 417.890.6788

mbpros
Posts: 312
Joined: Fri Mar 11, 2011 6:59 pm

Re: Dx Error for Claims in Claims Management with ICD10

Post by mbpros » Tue Oct 20, 2015 4:59 pm

Thanks, Andrew. What is strange is that only some of the time do I have to place an ICD9 code in the ICD9 field.....Many times if I create a new code on the Diagnosis Code List using Encoder Pro and I only input the ICD10 code (so the ICD9 field is blank) the claims go through; again it only is some times that I have to enter the ICD9 code.
Steven Zats
Medical Billing Professionals

amy
Posts: 1
Joined: Tue Oct 20, 2015 8:35 pm

Re: Dx Error for Claims in Claims Management with ICD10

Post by amy » Tue Oct 20, 2015 8:41 pm

I'm having the same problem. The weird thing is that if I go to 'lists' and try to find the new codes that I've entered (for laterality, like low back pain right....instead of the ICD 10 code for low back pain 'unspecified' that was created with the converter tool by Medisoft), they aren't there. But they are in the system somewhere, because in transaction entry for a patient, I can pull up the diagnosis codes that I've entered in the drop down menu for diagnosis on the date of service.
If the problem truly is that you have to have an ICD-9 code with it on the diagnosis code list, that's impossible with the new laterality codes...there aren't ICD-9 codes for right or left anything....
Do you have any thoughts about why codes don't show up in the dx. code list under 'lists,' but I know they're in there somewhere, because I can find them in transaction entry?
I get an error message if I try to use any of those dx codes that I've entered. They turn red, won't print, and the error message says 'The Diagnosis code set mapped for your primary insurance is missing for the following diagnosis codes: M25.551'

Andrew
Posts: 153
Joined: Tue Mar 19, 2013 3:24 pm
Location: Springfield, MO
Contact:

Re: Dx Error for Claims in Claims Management with ICD10

Post by Andrew » Wed Oct 21, 2015 8:08 am

Amy. If you go in to Lists>Diagnosis Lists. Uncheck the ICD10 and ICD9. You will notice that the codes listed will not have ICD9 field or ICD10 field filled in. These need to be filled in. If for some reason you cant find them by doing that. Then go to where you picked them up in the drop down of transaction entry. Either right click and hit edit or hit F6. This will show you 3 areas. "Code" This is the internal code, "ICD9" this is the ICD9 code, and last is "ICD10" These ICD9 and 10 Fields need to be filled out. This is why they are showing up red.
Andrew Analla
Support Team
MedTech Medical Management Systems
3058 S Delaware Ave
Springfield, MO 65804
Ph: 417.890.6777 | Fax: 417.890.6788

dkennelly
Posts: 62
Joined: Tue Oct 21, 2008 5:18 pm

Re: Dx Error for Claims in Claims Management with ICD10

Post by dkennelly » Fri Dec 04, 2015 2:27 pm

Andrew, some of my codes are also coming up red. They still process though. I have checked the diagnosis list, and I have all the code entries filled in. Is there some other reason they would be coming up red? It's not preventing the claims from being processed and paid, but if it's something I can fix, I will. Thanks

User avatar
Gavin Walker
Posts: 4625
Joined: Wed Apr 04, 2007 10:11 pm
Location: Springfield, MO
Contact:

Re: Dx Error for Claims in Claims Management with ICD10

Post by Gavin Walker » Fri Dec 04, 2015 9:33 pm

The red indicator indicates that Medisoft calculated you need an ICD-9 or ICD-10 code, but the code you entered doesn't have a mapping for the computed code. Also, Medisoft v19 had a bug with self pay patients after 10/1/2014 and you enter a code that doesn't have an ICD-10 mapping. Keep in mind, you could have more than one payer in the billing sequence so the code you enter might need a mapping for both if you have a case where one payer needs ICD-9 and another payer needs ICD-10.
Gavin Walker
Walker Tek Solutions, LLC
417-890-6777 x0
fax: 417-763-6386

dkennelly
Posts: 62
Joined: Tue Oct 21, 2008 5:18 pm

Re: Dx Error for Claims in Claims Management with ICD10

Post by dkennelly » Mon Dec 07, 2015 1:58 pm

What do you mean by mapping for both? When I pull up my diagnosis list, and check "show ICD 10", all of my icd 10 codes also have an icd 9 listed. The code in the transaction window is an icd10 code. The insurances are checked for the icd 10 start date of 10-1-15 and all of my dates of service are after this date. Like I said, they're all still processing fine, it's just I have a thing against the red showing up! and want to make sure I'm not missing something :-)

User avatar
Gavin Walker
Posts: 4625
Joined: Wed Apr 04, 2007 10:11 pm
Location: Springfield, MO
Contact:

Re: Dx Error for Claims in Claims Management with ICD10

Post by Gavin Walker » Mon Dec 07, 2015 4:55 pm

Edit your diagnosis code. There is a field for ICD-9 and ICD-10 code. Those are your mappings.

dkennelly
Posts: 62
Joined: Tue Oct 21, 2008 5:18 pm

Re: Dx Error for Claims in Claims Management with ICD10

Post by dkennelly » Tue Dec 08, 2015 10:28 am

I have both of them filled in!

User avatar
Gavin Walker
Posts: 4625
Joined: Wed Apr 04, 2007 10:11 pm
Location: Springfield, MO
Contact:

Re: Dx Error for Claims in Claims Management with ICD10

Post by Gavin Walker » Tue Dec 08, 2015 8:16 pm

Well, there are a lot of variables with how Medisoft calculates an invalid diagnosis code and like Andrew said, there are bugs. You'll probably need to work direct with your Medisoft support on this one.

Post Reply