Author Topic: ICD 10 Conversion  (Read 517 times)

Chiro Billing Collect

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ICD 10 Conversion
« on: February 09, 2017, 01:10:06 PM »
I am having an extremely difficult time getting the US Dept of Labor to pay for chiropractic care due to a dx conversion issue. The patient's accepted condition during the time of ICD-9 codes was 839.1 (Open dislocation of cervical vertebra). Claims were paid, no problems. When codes converted to ICD-10, the provider's office was solely responsible for finding the new accepted condition code. I tried billing S13.101A (dislocation of unspecified cervical vertebra) which was denied for not being specific enough. I then identified the specific vertebra C5-C6 and billed S13.160A which was denied as an unaccepted condition. The representative noted that the code was "subluxation" instead of dislocation. I asked if S13.161A would be paid since that is "dislocation of C5/C6 vertebra" and she said no. I have reached out to two claims examiners who have stated they do not provide the conversions for the accepted conditions. Besides changing the code from one level of vertebra to another, I can't find any other codes that resemble the original, open dislocation of cervical vertebra-839.1.  Any ideas?? Thank you!!

kristin

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Re: ICD 10 Conversion
« Reply #1 on: February 09, 2017, 04:53:07 PM »
The S13.161 is the correct code, from what I can see. It is dislocation, not subluxation, and is for C5/C6.

Do you think the problem could be with using "A" as the seventh character, as opposed to using "B", or even "D"?

Chiro Billing Collect

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Re: ICD 10 Conversion
« Reply #2 on: February 13, 2017, 10:19:10 AM »
That is a good question. I am going to call back again. A different rep may have the answer.