What is a claim scrubber?

A claim scrubber checks a claim for errors before it is submitted, so it is rejected or denied less often. Most scrubbing happens at the clearinghouse, after the coder has moved on. This one runs at the point the codes are chosen, which is the only place the error is cheap to fix.

Is this claim scrubber really free?

Yes. Up to five diagnosis codes per check, with the complete set of ICD-10-CM checks and no account required. The paid workspace removes the code limit and adds Medicare coverage policy by state, fee estimates, and HCC/RAF scoring.

Does it check CPT or procedure codes?

Not yet. CPT codes aren't included, so this scrubber sets them aside and tells you so rather than checking them. It covers ICD-10-CM diagnosis codes, which are public-domain CDC data.

Free tool

Free ICD-10 claim scrubber

Paste the diagnosis codes from a claim and we will tell you what would reject it: Excludes1 conflicts, header codes billed as specific, codes still missing a seventh character, laterality contradictions, and unmet sequencing rules. Every finding quotes the ICD-10-CM note it came from. No signup, no card, no email.

Free for up to 5 codes. We do not store what you paste, and please do not paste patient identifiers: we do not need them and do not want them.

What it checks

Every rule below is published by CMS in the ICD-10-CM tabular list. The failure is almost never that a coder did not know the rule existed: it is that the rule lives three tabs away and the claim is due.

Excludes1 conflicts: Two codes ICD-10-CM says can never be billed together. The most common ICD-10 denial there is, and the hardest to see: the rule lives in a note on one code and names another.
Non-billable header codes: E11 is a category, not a code. Submit it and the claim bounces for lack of specificity. We tell you which child codes to use instead.
Missing 7th characters: S72.001 is not a complete code. It needs one of A/D/G/K/P/S, and we list what each one means rather than making you look it up.
Laterality contradictions: The left and the right of the same condition, coded separately, with no bilateral code. Nearly always a copy-paste artefact in the chart.
Unmet sequencing rules: A manifestation coded without the underlying cause its 'code first' note demands.
Unspecified codes with specific alternatives: Not an error, but payers scrutinise them, and if the chart supports specificity you should know a specific sibling exists.

The denial codes these checks prevent

Each of these comes back on a remittance because of something a scrub would have caught before the claim left. The page for each code says what triggers it and how to stop it recurring.

CO-16: The claim is missing information the payer needs, or something on it is inconsistent. It is the most common denial there is, and on its own it tells you almost nothing: the useful detail is always in the remark codes sitting next to it.
CO-50: The payer does not consider the service medically necessary for the diagnosis you submitted. In Medicare, this almost always means the diagnosis is not on the covered list in the applicable coverage policy for your jurisdiction.
CO-11: The diagnosis does not match the procedure. The payer is saying the reason you gave for the service does not justify the service you performed.
MA130: Your claim is unprocessable: something on it is incomplete or invalid, and (this is the part that matters) it comes with no appeal rights, because in the payer's eyes no claim was ever properly filed. Fix it and submit fresh; do not waste an appeal on it.

All 44 denial codes explained

Common questions

What is a claim scrubber?: A claim scrubber checks a claim for errors before it is submitted, so it is rejected or denied less often. Most scrubbing happens at the clearinghouse, after the coder has moved on. This one runs at the point the codes are chosen, which is the only place the error is cheap to fix.
Is this claim scrubber really free?: Yes. Up to five diagnosis codes per check, with the complete set of ICD-10-CM checks and no account required. The paid workspace removes the code limit and adds Medicare coverage policy by state, fee estimates, and HCC/RAF scoring.
Does it check CPT or procedure codes?: Not yet. CPT codes aren't included, so this scrubber sets them aside and tells you so rather than checking them. It covers ICD-10-CM diagnosis codes, which are public-domain CDC data.

What it does not check

Procedure codes. CPT codes aren’t included yet, so they are set aside rather than checked. NCCI bundling edits and MUE limits ship together with CPT support.
Medical necessity and payer policy. Whether your Medicare contractor accepts a diagnosis as supporting a service is jurisdiction-specific, and it genuinely differs between states. That is in the paid workspace, not here.
The 837 itself. Demographics, eligibility, modifiers, place of service: none of that is here. A clean result is not a guarantee of payment.

Reading the list of what a tool cannot do is usually more informative than reading what it can, so we put ours where you can find it. If you want the checks this one leaves out, the paid claim scrubbing and denial prevention pages explain what is in them.