Blank DGNS_DRG_CD and PRNCPL_DGNS_CD

[Lightbeam Development]

We work with a client that is concerned about the number of blank codes for both DGNS_DRG_CD and PRNCPL_DGNS_CD.  We have 11k NULL DGNS_DRG_CD codes and almost 1k "0000" codes pulled from August 31st BCDA data.  We have 9k NULL and 500+ "0000" DGNS_DRG_CD codes from early August from BCDA.  In addition, we have 10k NULL PRNCPL_DGNS_CD codes from first weeks of July data and 1.5k from end of August data.  Nothing has changed on our side for BCDA loading.  Do you know anything that could have caused this?

Thanks for any help!

Lb

[Beneficiary Claims Data API (BCDA) Community]

Hi  Lb,

We are sorry to hear about the missing diagnosis codes in your client's BCDA claims data. In support of our investigation, please share the following:

1. The 5 character Entity ID for the effected organization(s). For example, ACOs in the Shared Savings Program have Entity IDs which begin with the letter 'A' followed by four numbers, like "A9999".
2. If the affected organization is participating in ACO REACH, whether or not this is happening for both adjudicated (Explanation of Benefit Resources) and partially adjudicated (Claim and Claim Response Resource) data.
3. Whether or not an admitting diagnosis code is available in claims where the principal diagnosis code is NULL or "0000".
4. Whether this high frequency of missing diagnoses codes is happening in the BCDA claims data for other organizations you are working with.

Feel free to add additional key details, and be sure to redact PII and other sensitive information.

Thank you in advance,

The BCDA Team

[Lightbeam Development]

Thanks for the reply.

The entity id is D.0162.  We aren't pulling the Claim and Claim Response Resource data.  We haven't seen this issue with other organizations.  ADMTG_DGNS_CD is NULL as well.