Hi CO16 to us is that medical records are needed.

On the Diagnosis and think this was on some other emails.

We use Epic.

Concerning the DX.

There is an edit that was built in Epic.

It stops claims that have the old diagnosis on a 30 day claim that is both Sept/Oct.

Those are then worked by coding/compliance to correct.

Claim will release after correction. Our clearinghouse is Change Healthcare, who also has edits from the payers.

Thank You!

Stefanie Leavstrom

Lead Insurance Representative • Central Business Office • Allina Health

Phone: 612-262-1760 • Fax: 612-262-6755 • Stefanie.Leavstrom@allina.com

Mail Route 10860 • 2925 Chicago Ave • Minneapolis, MN 55407-1321

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
Sent: Wednesday, February 8, 2023 2:53 PM
To: billers@list.mnhomecare.org
Subject: [External Mail] BCBS Episodic denial code CO16

CAUTION: This email originated from outside of the Allina Health network. Do not click links or open attachments unless you recognize the sender and know the content is safe.

Hi Everyone,

Is anyone having problems with claims coming back with denial code CO16?

BCBS Episodic Medicare has given us the following reasons for this denial:

1. Diagnosis code (September-October 2022 date span with a diagnosis code update. They are telling us to split up the claim. Sept with old dx, and Oct with new but this is episodic so that will reduce payment)

2. 30-day billing period (Incorrect review of 30-day billing date span on manual review, shorting the billing period one day)

3. NOA issues (the NOA is not processed before the first billing period is processed, causing a denial of the first billing period).

If so, have you been able to resolve the issues?

Thank you!


"We Improve People's Lives"	Mary Aaby CFO Interim HealthCare of the Twin Cities 2680 Arthur St \| Roseville MN 55113 651-259-4230 \| Mobile: 715-977-0827 \| Fax: 651-259-4245 .

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