Medicare Compliance & Reimbursement

Reader Question:

Avoid Deviating From the Dictation Report Diagnoses

Question: I’ve got a report without a diagnosis that meets the CPT® code’s Local Coverage Determination (LCD) requirement, but the diagnosis on the order does meet the LCD requirement. Can I submit the claim using the ordering diagnosis? Ohio Subscriber Answer: There are a few points to unpack here. First, you should not submit a claim with a diagnosis the [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more