tci Part B Insider - 2018 Issue 5

Part B Coding Coach: ICD-10: See How 'Medical Necessity' Factors into GI Surgery Pay

Tip: Pinpoint coding to correspond with symptoms and final diagnoses. With a plethora of diagnosis codes available, coders can truly differentiate between various conditions for gastrointestinal surgery claims. This myriad of options can also significantly boost your practice's procedure pay. Because the surgeon or the referring clinician may describe symptoms that are the indication for surgery, you'll need to be able to "decode" any narrative diagnoses you receive, and report the best ICD-10 code. Remember: You should wait for the pathology report, when possible, and list the final diagnosis on the claim. Without that information, you'll need to report...

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