Should You Appeal When A New Code Claim Isn’t Paid? HIPAA regulations are in place to prevent medical billing games. When current procedural terminology codes and ICD-9 codes are introduced, they have a certain effective date attached to them. This effective date states the very last day in which payers and providers must recognize the new code. It is illegal to deny claims for medical billing non-recognition. Providers deny claims all the time. There are various reasons for claim denials. These can range from a non covered service, to not substantiating medical necessity for a service. However, it is against the rules to deny medical billing because their system doesn’t …