tci General Surgery Coding Alert - 1999 Issue 3

Using Correct Diagnosis Code Critical to Getting Paid with "For" Codes

A lot of attention is paid to in addition to codes and separate procedures, but there is another, far lesser known kind of CPT code that restricts utilization to a specific diagnosis. And the consequences of misusing these codes can be dire, according to Georgeann Edford, RN, MBA, who heads Coding Compliance Solutions, a medical reimbursement firm in Birmingham, MI.Edford calls this group of codes for procedures, because each can only be used for a specific diagnosis listed in CPT 1999. Some examples of CPT codes relating to general surgery in this category are: 43846, gastric restrictive procedure...

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