|Rejection Message||Rejection Details||Resolution|
|PRINCIPAL DIAGNOSIS CODE IS MISSING OR INVALID FOR DIAGNOSIS TYPE GIVEN (ICD-9, ICD-10) OR CANNOT BE EXTERNAL CAUSE CODE||
This rejection indicates the claim was submitted with an invalid diagnosis (ICD-10) code.
The principal diagnosis cannot be an external cause. New edits had been placed for ICD-10 codes on 10/1/2016.
2. Check an up to date ICD Code Book (or online code resource) to make sure ALL diagnosis codes submitted on the claim are valid for the date of service being billed.
Utilizing this feature for all encounters can help prevent code rejections.
Follow the instructions below to edit a diagnosis code:
2. Look for and double-click on the encounter that needs correcting.
3. On the Edit Claim window, double-click on the Encounter number.
4. Click into the appropriate Diag cell and replace the diagnosis with a valid code.
Then, resubmit all affected claims.