tci General Surgery Coding Alert - 2018 Issue 4

ICD-10: Don't Let 'Medical Necessity' Gap Undermine GI Surgery Pay

Focus coding for reported symptoms and final diagnoses. When your general surgeon takes a case for gastro-intestinal surgery, you can't afford to miss the diagnosis code that most accurately describes the condition - and ensures appropriate procedure pay. Because the surgeon or the referring clinician may describe symptoms that are the indication for surgery, you'll need to be able to "decode" any narrative diagnoses you receive, and report the best ICD-10 code. Remember: You should wait for the pathology report, when possible, and list the final diagnosis on the claim. Without that information, you'll need to report the signs...

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