Alert 10011 (Excludes)
Description:Â Errors in this edit are generated if a particular ICD-10-CM code is included in Excludes 1 note list for another diagnosis. One error is generated for every code in the Excludes 1 note list.
Edit ID:Â 10011
Error type:Â ERROR
Error message example 1:
This example is provided for the following scenario:Â
- The claim has principal ICD-10-CM code = O03.34.
- The claim has secondary ICD-10-CM code = Z34.80.
- Greenrain MNC generates one error for diagnosis code Z34.80.
Diagnosis code Z34.80 is on the Excludes 1 note list for diagnosis code O03.34.
DESCRIPTION
Principal diagnosis code O03.34 = Damage to pelvic organs following incomplete spontaneous abortion
Secondary diagnosis code Z34.80 = Encounter for supervision of other normal pregnancy, unspecified trimester
Error message example 2:
This example is provided for the following scenario:Â
- The claim has principal ICD-10-CM code = P37.0.
- The claim has secondary ICD-10-CM codes = A18.5, R76.11, J65 and A02.21.
- Greenrain MNC generates errors for diagnosis codes P37.0, R76.11 and J65 because all three of them are included in Excludes 1 note list for code A18.5.
Error for code P37.0
Diagnosis code P37.0 is on the Excludes 1 note list for diagnosis code A18.5.
DESCRIPTION
Principal diagnosis code P37.0 = Congenital tuberculosis
Secondary diagnosis code A18.5 = Tuberculosis of eye
Error for code R76.11
Diagnosis code R76.11 is on the Excludes 1 note list for diagnosis code A18.5.
DESCRIPTION
Secondary diagnosis code A18.5 = Tuberculosis of eye
Secondary diagnosis code R76.11 = Nonspecific reaction to tuberculin skin test without active tuberculosis
Error for code J65
Diagnosis code J65 is on the Excludes 1 note list for diagnosis code A18.5.
DESCRIPTION
Secondary diagnosis code A18.5 = Tuberculosis of eye
Secondary diagnosis code J65 = Pneumoconiosis associated with tuberculosis
Owner object:Â Diagnosis
Owner object property name:Â Code
Owner object property value: Value of Diagnosis.Code
Reference object:Â Claim
Reference object property name:Â ID
Reference object property value:Â Value of Claim.ID