tci Part B Insider - 2006 Issue 12

DIAGNOSES CODING: Symptoms But No Diagnosis--How Do You Bill Tests?

Know the difference between covered and non-covered symptomsSometimes your doctor orders diagnostic tests without knowing the patient's exact diagnosis--after all, that's what diagnostic tests are for. But many payors and carriers won't reimburse you for costs associated with diagnostic tests for vague symptoms. Here's what to do.The challenge: You're technically not supposed to bill for the diagnosis that the laboratory gives you after the test comes back because you're supposed to bill the diagnosis that justified the test originally, explains consultant Maxine Lewis with Medical Coding Reimbursement Management in Cincinnati. But many practices do bill for the diagnosis...

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