The following are questions that have recently come through the AAP FaxBack Coding Hotline. If you have questions that need to be answered, please call the hotline at 800/433-9016, ext 4022, or e-mail aapcodinghotline@aap.org. This is a free member service.

A carrier is denying some of our claims that have a 3-digit International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM) code, saying it no longer accepts 3-digit codes. What should we do?

First of all, you need to clarify whether the carrier is denying a 3-digit code as invalid or incomplete because it is missing a fourth or fifth digit (as listed in ICD-9-CM), as opposed to a carrier denying any and all 3-digit codes. There are occasions when a physician’s staff may not be familiar with the ICD-9-CM code book and unclear on the use of fourth or fifth digits.

Secondly, carriers at times do not...

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