Description:
Errors in this edit are generated when all below conditions are met:
- Encounter type is inpatient or unknown, and
- Icd10Code.IsUnacceptablePrincipalDiagnosis = True, and
- The ICD-10-CM code is a Principal Diagnosis.
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. Refer to /wiki/spaces/FRG/pages/1833762851 for more details.
Edit ID: 10010
Error type: WARNING
Error message example 1:
This example is provided for the following scenario:
- Principal ICD-10-CM code = H40.1233.
- 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:
- Principal ICD-10-CM code = H40.1233.
- 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