Claims Denials Claiming ICD-10-CM Problems?
Several members have contacted the ICS this week about claim denials from Blue Cross Blue Shield of Illinois (BCBSIL). It appears that BCBSIL has begun to use a claims edit process called “Excludes1” described in ICD-10. This process may result in certain claim denials, as explained in the video. ICS Members can also access the ICD-10 reference sheet here.
Important Note: The video indicates to “resubmit” the bill. Instead, please file a corrected claim. Do not resubmit – file a corrected claim.