Our billing system only allows us to assign four diagnosis codes for each claim. This is the scenario: A patient with RUOQ breast cancer is being treated. Metastatic sites that are being addressed in this visit are liver, bone, and bilateral lungs. How would you best represent this with only four codes? Would you only code one lung site (C78.01), or perhaps use the unspecified lung mets code? (C78.00). Interested to see how other coders would handle this. Thanks in advance!
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Wiki 4 DX CODE LIMIT
- Thread starter dmcdowell
- Start date
thomas7331
Guest
If the documentation doesn't suggest that any diagnosis was of greater importance to the encounter than another, then it's really just a toss of the coin - just take your pick. I'm assuming that this is for a professional service, so as long as you've met the medical necessity of whatever you're billing, it's not going to make any difference to the payment. It's the kind of thing where if you spend too much time thinking about it, you'll cost your provider more than the value you're adding. 
Even if you can only link 4 ICD codes per charge line, you should be able to have 12 ICD codes altogether. What system do you use?