What will a payer do when a claim is submitted with a diagnosis code that is not valid for the date of service?
A) Payers may deny a claim when outdated codes are used.
B) Payers will not respond to the claim.
C) Payers are not permitted to deny a claim when outdated procedure codes are used.
D) Payers will typically pay and submit the claim to the provider with the correct procedure codes.

Question

Quizplus · Accepted Answer

Payers may deny a claim when outdated or invalid diagnosis codes are used because these codes do not match the services provided on the date of service, leading to issues with claim processing and reimbursement.

What Will a Payer Do When a Claim Is Submitted