Alert 10010 (Unacceptable Principal Diagnosis)

Owned by Roman Konovalov
Last updated: Aug 11, 2020Version comment
1 min read

Description:

Errors in this edit are generated when all below conditions are met:

  1. Encounter type is inpatient or unknown, and
  2. The principal ICD-10-CM code is unacceptable.

The Unacceptable Principle Diagnosis is generated as a warning and not an error since it is a Medicare Code edit to show that the given code cannot be used as Principle Diagnosis for an inpatient claim.

Edit ID: 10010

Error type: WARNING

Error message example 1:

This example is provided for the following scenario:

  1. Principal ICD-10-CM code = H40.1233.
  2. Encounter type is inpatient.

Principal diagnosis code H40.1233 cannot be used as Principal Diagnosis for Inpatient Admission as per Medicare Code Edits.

DESCRIPTION

Principal diagnosis code H40.1233 = Low-tension glaucoma, bilateral, severe stage

Error message example 2:

This example is provided for the following scenario:

  1. Principal ICD-10-CM code = H40.1233.
  2. Encounter type is unknown.

Principal diagnosis code H40.1233 cannot be used as Principal Diagnosis for Inpatient Admission as per Medicare Code Edits. Encounter type of this claim is unknown.

DESCRIPTION

Principal diagnosis code H40.1233 = Low-tension glaucoma, bilateral, severe stage

Owner object: Diagnosis

Owner object property name: Code

Owner object property value: Value of Diagnosis.Code

Reference object: Claim

Reference object property name: ID

Reference object property value: Value of Claim.ID