tci Medicare Compliance & Reimbursement - 2009 Issue 7

CODING COACH : Keep Chronic Pain Denials at Bay With Surefire Diagnosis Tips

Be careful not to put words in your physician's mouth, or risk audit woes. Imagine your physician treats a chronic pain patient,but during the visit your physician isn't able to uncover a definitive diagnosis. While you know that altering or guessing a diagnosis to ensure payment is wrong, there are codes you can choose from to handle the situation. Here's what you need to know:Interpret Doc's Docs For Help Specificity in diagnosis coding is always important,but it is increasingly vital because "third-party payers are establishing more stringent coverage criteria for therapies and procedures and are using automated...

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