Feeding Claim Rejected - Diagnosis Code R63.3 - Your Questions Answered
Published: May 09, 2024
Last updated: May 09, 2024
Feeding Claim Rejected - Diagnosis Code R63.3 - Your questions answered
Scenario: I attempted to submit a feeding claim, and in the EDI 277s claim response, the claim was rejected with the following error message: Diagnosis code 4(d) is not billable (further specification required). Why?
Answer: Code R63.3 is an older code that is no longer valid for reimbursement for many insurance payers. Insurances are expecting to see a more specific code as of this year.
Answer: Code R63.3 is an older code that is no longer valid for reimbursement for many insurance payers. Insurances are expecting to see a more specific code as of this year.
2024 ICD-10-CM Diagnosis Code R63.3
Feeding difficulties
- R63.3 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail.
- The 2024 edition of ICD-10-CM R63.3 became effective on October 1, 2023.
- This is the American ICD-10-CM version of R63.3 - other international versions of ICD-10 R63.3 may differ.
Source: 2024 ICD-10-CM Diagnosis Code R63.3: Feeding difficulties (icd10data.com)
Here are some other feeding codes that are reimbursable and more specific.
Feeding Codes (Updated October 1, 2021)
- R63.31 - Pediatric Feeding Disorder, acute
- R63.32 - Pediatric Feeding Disorder, chronic
- R63.39 - Other feeding difficulties
- Feeding problem (elderly) (infant) NOS
- Picky eater
To resolve this rejection error, please edit your patient's diagnosis code to reflect one of these more specific feeding codes from the drop down. Then resubmit the claim with the new information.
How to Add or Edit a Diagnosis Code: https://ambiki.com/help/faqs/how-to-add-or-edit-a-diagnosis-code
Samuel Okoth