AHA Coding Clinic® for ICD-9 - 2012 Issue 1; Ask the Editor

Code Number in Lieu of a Diagnosis

Since our facility has converted to an electronic health record, providers have the capability to list the ICD-9-CM diagnosis code instead of a descriptive diagnostic statement. Is there an official policy or guideline requiring providers to record a written diagnosis in lieu of an ICD-9-CM code number? ...

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