Part B Insider - 2016 Issue 12
Reader Question: Scan the Documentation to Arrive At a Specific Conjunctivitis Code
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Article Overview
This article addresses a reader question about conjunctivitis coding in ICD-10-CM and why an unspecified diagnosis may be denied by payers. It focuses on the need to review documentation for greater clinical specificity, including cause and laterality, and it frames the issue as a common coding documentation concern for payers and providers.
Why This Topic Matters
It helps coding professionals understand why a previously accepted conjunctivitis diagnosis may now be rejected and what broader documentation elements matter for selecting a more specific ICD-10-CM code.
What You Will Learn
- Why a conjunctivitis diagnosis may require more specific documentation
- How payer expectations can change after an ICD-10 transition period
- What general documentation details are relevant to conjunctivitis code selection
- Why querying the provider may be necessary when specificity is missing
Who Should Read This
- Medical coders
- Coding auditors
- Billers
- Revenue cycle staff
- Clinical documentation improvement staff
Codes Discussed
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