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Urology Coding Alert

Reader Question:

Who Specified What Matters

Published on Wed Sep 17, 2003

Question: How do I determine if I should choose a "not otherwise specified" diagnosis code or "not elsewhere classified"?
Florida Subscriber
 
Answer: The difference between "not otherwise specified" (NOS) and "not elsewhere classified" (NEC) is that one reflects your physician's documentation shortcomings while the other reflects your ICD-9-CM's shortcomings, respectively.
 
You should use an NOS code when your physician fails to document a more specific diagnosis for a patient whose condition requires a five-digit diagnosis code. These codes are highlighted in yellow in the ICD-9-CM expert edition manual published by Ingenix. The NEC codes, on the other hand, are highlighted in gray. Use these codes when there is no diagnosis code in the manual that is as specific as your physician's documented findings.
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