"Unspecified Codes" clinical edit goes into effect on Oct. 11, 2022

Diagnosis codes should be reported to the highest level of specificity. On October 11, we'll turn on a new clinical edit that will deny certain unspecified diagnoses codes designated as either a Complication or Comorbidity (CC) or Major Complication or Comorbidity (MCC) when reported on an inpatient claim.

This edit will impact facility providers and will apply to all product types.

For more details on recent and upcoming clinical edits, visit our Clinical Edits Listing webpage.