BC Advantage - 2024 Issue 2

Should I Report the Symptom or Confirmed Diagnoses for Testing?

Coders frequently ask questions about the guidelines surrounding coding symptoms vs. confirmed diagnoses, especially when tests are ordered during an encounter to rule out a condition, illness, or disease.   Frequently Asked Questions   The following questions were submitted for review along with others that were similar:   A patient comes in with a sore throat and the provider orders a strep test, which has a positive result. The physician documents that the test was positive and writes a prescription for an antibiotic. Should J02.0 (strep throat) or J02.9 (sore throat) be reported when billing for the...

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