ICD Code Exceptions
Some states and insurers have published lists of ICD codes that are not allowed for workers' compensation and can cause a claim to be rejected or denied.
Codes that are unacceptable for invoices or those that you no longer want
to use should be entered in the ICD Exceptions table. Codes entered into the table
continue to display in ICD lookup lists. When you select one of these codes for an
injury diagnosis or invoice and save the record, a message displays that the code is
an ICD exception.
- Click No to use a different ICD code. A message instructs you to correct the code. Click OK and select an ICD code from the lookup list.
- Click Yes to leave the excepted ICD code in place. The message does not display again if the code is included in an injury diagnosis or invoice for that injury.
Note: Selecting a different ICD code or leaving in the
excepted code does not remove it from the exceptions table. A user with
administrative permissions can add or remove ICD codes.
If a code is disallowed in more than one state, you can leave the State field blank and list the disallowing states in the description. Another possibility is to use the Description field to suggest other codes that might be more appropriate.
