Claim Check: Validate Your ICD-10 Code List
Paste the diagnosis codes from a claim (up to 25 — 12 fit a CMS-1500, 25 a UB-04) and check every pair against the official CMS ICD-10-CM tabular data before the payer does. Deterministic, official-data-only, and free.
What Claim Check verifies
- Excludes1 conflicts — the tabular list marks certain code pairs as mutually exclusive. Reporting both, such as type 1 and type 2 diabetes together, is an error unless the two conditions are documented as unrelated (ICD-10-CM Official Guidelines, Section I.A.12.a).
- Sequencing instructions — when one listed code carries a Code First or Use Additional Code note covering another listed code, the report shows which must be sequenced first. Hypertensive heart disease with heart failure (I11.0) is sequenced before the heart failure code (I50.-) it instructs you to add.
- Billable status — non-billable header codes such as E11 (instead of E11.9) are flagged with the billable child codes to use instead, and codes absent from the current registry are called out as probable typos or retired codes.
Every finding quotes the official instruction it came from — nothing is generated or inferred. Payer-specific edits and medical-necessity policies are outside its scope.
Comparing just two codes? Use Compare Codes. Or look up a single code in the official registry.
Frequently asked questions
How many diagnosis codes can I check at once?
Up to 25. A CMS-1500 professional claim carries 12 diagnosis pointers and a UB-04 institutional claim carries 25, so the cap is the larger of the two and a whole institutional claim fits in one check. Every code is checked against every other, not just against the first.
What does Claim Check actually check?
Six things, all from the official CMS tabular data: Excludes1 conflicts between listed codes; Code First and Use Additional Code sequencing instructions that one listed code aims at another; non-billable header codes, with their billable children listed as replacements; codes that are not in the registry at all, which are usually typos or retired codes; codes whose tabular entry requires a 7th character they do not carry; and first-listed codes that CMS's Medicare Code Editor does not accept as a principal diagnosis.
Why is one of my codes flagged as not billable?
Because it is a header (category) code rather than a leaf code — E11 instead of E11.9, for example. Header codes group their children and are not valid on a claim, so payers reject them as insufficiently specific. The report lists the billable child codes underneath it so you can pick the one the documentation supports.
Does the date of service change the result?
Yes. ICD-10-CM changes every October 1, so the date of service determines which fiscal-year code set applies. Supplying it lets the report flag codes that were not valid on that date — an addition that had not taken effect yet, or a code that had already been deleted.
Does Claim Check cover payer edits, medical necessity or CPT?
No. It checks a code list against the official ICD-10-CM tabular rules only. Payer-specific edits, medical-necessity and coverage policies, and NCCI procedure-to-procedure edits are outside its scope, and CPT is AMA-licensed and not published here. A claim that passes every check here can still be denied on a policy this tool does not model.
Should I paste patient information into it?
No. Do not enter protected health information. The tool needs diagnosis codes and, optionally, a date of service — never names, dates of birth, medical record or member numbers, or clinical narrative.