MedicaidBilling CodesMedium impact
ICD-10-CM Emergency Diagnosis Codes and ICD-10 Diagnosis Codes for Medically Necessary Cesarean Sections Updated
Nevada Medicaid·NV · OB-GYN·Billing & Coding
Effective date
Jun 1, 2024
We identified it
Jun 21, 2026
Summary
Nevada Medicaid has corrected a system error that was incorrectly denying claims for Emergency Medical Only (EMO) and Medically Necessary Cesarean Section services when five specific ICD-10 codes were used as primary diagnosis codes. These codes are now accepted in the system effective June 1, 2024, and previously denied claims will be automatically reprocessed.
Action Required
Immediately: Billing team should monitor upcoming remittance advices for automatically reprocessed claims that previously denied with error code 4224 when using the five corrected ICD-10 codes (O34.211, O34.212, O34.218, O34.219, O75.82) as primary diagnosis for cesarean sections. Review reprocessed claim results and appeal any that remain denied if clinically appropriate. No system updates are required as Nevada Medicaid has already corrected their system.