Troubleshooting Claim Rejection Due to Missing Diagnosis Code

Issue:

You may encounter a situation where claims are failing to send and you see an error message stating that there is no primary medical diagnosis code, despite having an active diagnosis code present in the client profile.

Solution:

1. Review medical history

• Access the client’s profile.
• Navigate to the Medical History section.

2. Check diagnosis start date

• Ensure that the primary medical diagnosis has a start date entered.
• Note that an end date is not required, only a start date.

3. Update diagnosis information

• If the start date is missing, add the appropriate start date for the diagnosis.
• Save the changes to the client’s medical history.

4. Void the existing claims that failed to send

• Void the existing claims that were rejected.
• Re-generate the claims to include the updated diagnosis information.