Drug coverage policies are written as pairings of a HCPCS code with a list of acceptable ICD-10-CM codes. A clean claim with the wrong diagnosis is still denied.
The diagnosis code set used on US claims to state why a service was provided.
Drug coverage policies are written as pairings of a HCPCS code with a list of acceptable ICD-10-CM codes. A clean claim with the wrong diagnosis is still denied.