Reason Code 31276

Published 12/16/2019

Description
Outpatient claim contains an ICD Indicator of 9 and an ICD-10 diagnosis code is present. For 329 TOB if through date of service is prior to ICD-10 implementation date and claim contains ICD-10 diagnosis code the reason code will assign.

Resolution
For dates of service on and after October 1, 2015, entities covered under the Health Insurance Portability and Accountability Act (HIPAA) are required to use the ICD-10 code sets in standard transactions adopted under HIPAA.