01/30/2017

Billing with ICD-10 Code B35.1

Medicare did not reimburse this visit because they said, through a telephone conversation, that diagnosis code B351 was deleted October 1, 2016. Is this true? I went online to National Government Services and did not find any information about this diagnosis code being deleted. If this code has not been deleted, what other reasons would this claim be denied? The diagnosis pointer used was only for code M70872.

The information from NGS Medicare is incorrect. ICD-10 code B35.1 is still a valid code and would not have caused an office visit to deny. The reason the charge was denied by the Medicare carrier is most likely because of the use of ICD-10 code E08.9. While this is a valid code, none of the other three diagnosis codes billed are considered an underlying disease that caused the patient to be a diabetic, which is a pre-requisite for this non-specific diagnosis code. To have the service paid by Medicare, the recommendation is to resubmit a corrected claim with the following three ICD-10 codes, which are valid since ICD-10 was implemented, and not billing with code E08.9:

• M70.872- Other soft tissue disorders related to use, overuse and pressure, left ankle and foot
• B35.1- Tinea unguium
• M20.12- Hallux valgus (acquired), left foot