When using International Classification of Diseases, Clinical Modification (ICD-CM) codes, which of the following will occur when the fourth and fifth digits are omitted?

Question

Quizplus · Accepted Answer

Omitting the fourth and fifth digits in ICD-CM codes often leads to claim denials because these digits provide necessary detail about the diagnosis, which is crucial for the payer to process and approve the claim. Without this level of detail, the claim may not meet the payer's requirements for specificity, resulting in denial.

When Using International Classification of Diseases, Clinical Modification (ICD-CM) Codes