• E-mail
• Print
• RSS

Coding tip: Use proper diagnosis codes

Ambulatory Surgery Reimbursement Update, June 5, 2007

Medicare's Local Medical Review Policies (LMRP), Local Coverage Determinations (LCD), or National Coverage Determinations (NCD) may affect the procedures you perform, the services you provide, and the implants and supplies you use in your ASC.

These policies list covered diagnoses for certain procedures, which you must carefully follow to ensure proper reimbursement.

Diagnosis codes not listed on these policies used on a claim may result in a claim denial for medical necessity reasons. However, use of a diagnosis code on one of these lists for a procedure not performed on a patient is not allowed.

You can locate supporting diagnoses in the operative report, history and physical (H&P), and/or the pathology report.

This tip is brought to you by Ellis Medical Consulting, Inc.

• E-mail to a Colleague
• Print
• RSS
• Archive