tci Part B Insider - 2009 Issue 12

Part B Coding Coach : Keep Chronic Pain Denials at Bay With Surefire Diagnosis Tips

Be careful not to put words in your physicians mouth, or risk audit woes. Imagine your physician treats a chronic pain patient, but during the visit your physician isnt 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. Heres what you need to know. Interpret Docs 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...

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