Non-covered diagnoses — diagnosis code mapping for reimbursement/payment
Lists diagnoses that are considered non-covered and shows mappings between 'Commercial' and 'INTEGRITY' diagnosis codes for Neighborhood Health Plan of Rhode Island; affects claims adjudication and billing for providers submitting diagnoses listed.
No material clinical or coverage changes in this revision.
Non-Covered Diagnoses
Non-Covered Diagnoses
The following ICD-10 diagnosis codes are designated Non‑Covered. For each entry, the payer 'Commercial' mapping and the internal 'INTEGRITY' mapping are provided where available.
ALL of the following
N46.01–N46.9
- N46.01 to N46.9 — Non‑Covered; Commercial maps to L70.0 to L70.9; INTEGRITY maps to N46.01 to N46.9.
N52.9
- N52.9 — Non‑Covered; Commercial maps to L73.0; INTEGRITY maps to N52.9.
N97.0–N97.9
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