Allowing-MedicareClaims-with-Z-diagnosis-codes

The Centers for Medicare & Medicaid Services (CMS) provided guidance in the April 7, 2020, Dear Clinician letter for using diagnosis codes Z03.818, Z20.828, and Z11.59 when reporting encounters related to possible COVID-19 exposure. First Coast Service Options, Inc. (First Coast) was erroneously denying claims as preventive/screening services when submitted with diagnosis codes Z03.818 and Z11.59.

Resolution

Effective for claims processed on or after July 17, 2020, for dates of service on or after January 27, 2020, First Coast will no longer deny claims when submitted with diagnosis codes Z03.818 and Z11.59, as long as all other coverage requirements are met for claims processing.

Status/date resolved

Beginning July 17, 2020, for dates of service on or after January 27, 2020, claims will no longer be denied when billed with diagnosis codes Z03.818 and Z11.59.

Provider action

Also, no provider action is needed. Because First Coast will adjust impacted claims.

Current processing issues
Here is a link to a table of current processing issues for both Part A and Part B.

 

 

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