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July 31, 2017

New Edit– Reject Duplicate Diagnosis Codes

The following edit will be implemented for the payers listed beginning 10/1/2017

  • Blue Cross Blue Shield of Kansas (47163)
  • Blue Cross Blue Shield of Kansas City (47171)
  • HealthNow New York (55204)
  • BlueCross BlueShield of Western New York (00301 or 00801)
  • BlueShield of Northeastern New York (00800)
  • EDI Midwest
  • PHP

PURPOSE: An EDI front end edit for Institutional, Professional and Dental claims will be implemented to reject claims whenever a secondary diagnosis is coded the same as the principal diagnosis.

This edit is currently issued as a warning, but will become a rejection on 10/1/17.


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