tci General Surgery Coding Alert - 2001 Issue 11

Medicare Carriers Instructed To Accept Post-Test Diagnoses

Medicare carriers have long differed on whether physicians who perform diagnostic tests should report the diagnosis revealed by the test or the sign or symptom that prompted the test. Now CMS has ruled that the post-test diagnosis should be used.  A CMS transmittal (AB-01-61) issued on Sept. 26 states: "If the physician has confirmed a diagnosis based on the results of the diagnostic test, the physician interpreting the test should code that diagnosis. The signs and/or symptoms that prompted ordering the test may be reported as additional diagnoses if they are not fully explained or related to the...

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