tci General Surgery Coding Alert - 2007 Issue 12

Coding 101: Don't Jump the Gun on Diagnosis Coding

Medical necessity is not necessarily top priority If your diagnosis coding fails to support medical necessity for the services and procedures provided, carriers can deny claims outright or may require repayment (along with additional fines or even fraud investigations) at a later date. Even when a procedure or service is medically necessary and appropriate, faulty ICD-9 coding can derail the claim. Here are three tips to help you ace your diagnosis coding. 1. Think Accuracy First, Medical Necessity Second In all cases, you should strive first and foremost to report ICD-9 codes that accurately and completely describe the patient's...

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