tci Medicare Compliance & Reimbursement - 2022 Issue Q2

Reader Questions: Know the Facts on Listing Beneficiaries’ Conditions

Question: We find the Medicare billing process a bit confusing and aren’t sure what to include on our claims pertaining to our beneficiaries’ diagnoses. When preparing a claim, should we enter the diagnosis code only for the condition the physician is treating? Or should we list all the current conditions that the patient is experiencing? Ohio Subscriber Answer: The answer to this question is open to interpretation. ICD-10 Official Guidelines, Section IV.J, tells you to “code all documented conditions that coexist at the time of the encounter/ visit, and that require or affect patient care, treatment...

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