tci Part B Insider - 2005 Issue 13

Physician Notes: Don't Bill For Septic Shock Unless You Show Sepsis First

You can never report any codes from subcategory 995.9 (Sepsis) as the principal diagnosis, the Centers for Medicare and Medicaid Services clarifies. You 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. CMS didn't issue any new ICD-9 codes for April, but it did shake up the rules a little. CMS says you can't bill for septic shock unless you've documented sepsis, and you don't need an external cause-of-injury code with sepsis codes. If the doctor removes organs prophylactically because of a genetic predisposition...

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