Wiki billing codes vs chart codes

[sspeer]

Can anyone tell me if there are multiple codes by doc for a visit, do all codes need to be listed on hcfa (up to 5 ) or just 1 code since insurance only looks at the first code?
Also, does the dx code in chart have to be the same as billed?
I have been asked this question from a friend working in Opthamalogy. I would tell her that all codes should be listed so the insurance is aware of the treating dx and disorders. I also feel the chart should be the same as billing codes unless billing is using a more specified code for 2 diagnosis ie. bronchitis and pneumonia vs bronchopneumonia.
Thanks for your help.

 

[mitchellde]

first you get to put 12 dx codes on the 5010 transaction and the new 1500 billing form
you still can link only 4 dx codes per CPT code
The dx codes on the claim must reflect the documentation in the medical note, they do not have to match the code numbers selected by the provider as long as they are supported by the narrative document.
You use all code for all dx that are managed controlled or treated or are co-morbid to the reason for the encounter.
Insurance looks at all the dx codes listed, not just the first one.

 

[sspeer]

thanks. that's what i told her too.