tci Part B Insider - 2015 Issue 10

Neoplasm Coding: 3 FAQs Help You Hone Your Uncertain vs. Unspecified Diagnoses

Hold claims for pathology report when possible. You may not always be able to narrow down your diagnoses to a definitive code, which means you could have to turn to “uncertain” or “unspecified” codes. Make sure you aren’t missing a more specific diagnosis code and keep proper documentation in your defense.  Check out the answers to these three frequently asked “uncertain” vs. “unspecified” questions, and keep your neoplasm diagnoses straight. Question 1: How can we determine when to submit the “uncertain” codes? Answer: Using 238.2 (Neoplasm of uncertain behavior of skin)...

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