Following a
routine review of the Medicaid rejections received on EI Billing claims, PCG
found that some EI Billing Providers are billing claims with diagnosis code V79.3. This
code is not a billable ICD-10 code for claims with a date of service on or
after October 1, 2015. While
V79.3 was billable as an ICD-9 code with the description: “Screening for developmental handicaps in early childhood”, following
the transition to ICD-10, the description for V79.3 is now: “Bus occupant (driver) (passenger) injured
in unspecified non-traffic accident”.
There is a
group of ICD-10 codes related to screenings that can be used prior to a
diagnosis being made.
The ICD-9 code V79.3
converts approximately to ICD-10 code Z13.4
“Encounter for screening for certain developmental disorders in children”. Approximate
synonyms listed for this code include:
- Developmental
screening for autism in toddlers
- Developmental
screening for autism in toddlers done
- Developmental
screening for autism in toddlers done (situation)
- Developmental
screening for physical therapy, occupational therapy and speech therapy needs
- Screening
for developmental handicap
- Screening
for developmental handicap done
- Screening
for developmental handicap done (situation)
- Screening
for developmental problems in early childhood
- Screening
for developmental problems in early childhood done
- Screening
for developmental problems in early childhood done (situation)
- Screening
for physical therapy, occupational therapy and speech therapy needs for
developmental delay
Translating
from an ICD-9 code to an ICD-10 code may be done in a number of ways:
- The
EIP provider may request the practitioner that originally conducted the
evaluation or wrote the prescription, order, written recommendation, or
referral containing the ICD-9 code to provide the ICD-10 code to be used on and
after October 1, 2015
- The
EIP provider may request the child’s primary health care provider to
“translate” the “reason/need” wording or the ICD-9 to an appropriate ICD-10
code
- Consulting
coding books and resources
- Consulting
coding professionals with adequate experience
- Contacting
physicians or other health professionals
If you have any
questions, please contact the PCG Customer Service Call Center at (866)
315-3747.
Article ID: 343, Created On: 1/3/2017, Modified: 1/3/2017