tci Part B Insider - 2016 Issue 7

ICD-10 Coding: Don't Automatically Assign Admitting Diagnosis on Discharge Claims

A patient’s diagnosis can change over the course of a hospitalization. Just because a patient enters the hospital with one condition doesn’t mean she’ll have that diagnosis for her entire stay. And if you bill for your physician’s hospital visits with an out-of-date diagnosis, you could lose money or face fraud charges. The problem: Diagnoses can change in the hospital due to various reasons, including the following, among others: The physician may narrow down the patient’s problem. For example, a patient may be admitted with chest pain, and the doctor may rule out myocardial...

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