ICD-10 DME Crossover Issue Resolved

On Friday, October 2, it was determined that some DME crossover claims were denying ICD-9 codes for diagnosis edit 00190 "DIAGNOSIS NOT VALID� when the claim dates of service span beyond October 1, 2015. We immediately notified providers of the issue.

We corrected the edit 00190 issue with DME crossover claims on Sunday, October 4.

The affected claims will be reprocessed this week. Providers do not have to do anything. The reprocessed claims will appear in the Remittance Advice (RA) for the October 14 checkwrite.

Note that reprocessing does not guarantee payment for the claim. The reprocessed claims are subject to any other edits already in place. Therefore, the reprocessed claims could deny for another reason.