tci Part B Insider - 2010 Issue 21

Diagnosis Coding: Your Physician's Notes Reveal Diagnosis Codes -- You Just Have to Know Where to Look

If the doctor does not circle a diagnosis, it may be up to you to find one. Don't let an incomplete superbill damage your chances of submitting an accurate claim. If the doctor in your office fails to indicate the ICD-9 code for the condition that he treated, you should read through his documentation to find which diagnoses you should report. Open the Notes When You Have to -- and Even When You Don't Suppose your physician hands you a superbill with the procedures circled and the diagnosis left blank. You could ask the physician which diagnosis to report...

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