tci Medicare Compliance & Reimbursement - 2005 Issue 16

PHYSICIANS: Show Septis, Then Bill For Septic Shock

Clarifications, not new codes, highlight ICD-9 changes.If you're a physician treating a patient with septic shock, make sure the condition is a secondary diagnosis on the encounter form.Why? The Centers for Medicare and Medicaid Services has released a clarification on rules regarding diagnosis coding for patients with septic shock. The clarification explains that a physician's office should never report any codes from ICD-9 subcategory 995.9 (Sepsis) as the principal diagnosis. Instead, the physician must assign the underlying systemic infection code first. That's just one of the changes in the April 1 revision to the ICD-9 guidelines...

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