# Primary diagnosis



## abyrne (Feb 6, 2019)

Am I understanding this correctly, if a code has the symbol indicating “unacceptable principal diagnosis per Medicare code edits” does this apply to all types of services or is this for facility only?


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## pscanlan (Feb 7, 2019)

aboncher said:


> Am I understanding this correctly, if a code has the symbol indicating “unacceptable principal diagnosis per Medicare code edits” does this apply to all types of services or is this for facility only?


This is probably going to vary based on the publisher of your manual, the version, etc. If you're looking at some codebook that's geared towards facility coding, there might be differences. However I should think that in the standard AAPC ICD-10-CM book, that warning would apply to all possible uses of the code, whether facility or outpatient, so long as Medicare is the payer. I'd find another code. I could be off the mark though, really can't tell without specifics.


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## mitchellde (Feb 7, 2019)

In most of the books I have looked in the symbol indicating unacceptable principle dx code means unacceptable as the principle dx code for inpatient admission.  If you look at these it makes perfect sense.  for instance Z00.00 indicates unacceptable principle dx but it is also a first listed only allowed code.  so it is not acceptable as an admit dx but when using it for an office encounter it must be the first listed code.


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