Wiki Help! Dx code vs V code

Create Wiki
M

mysticd

Guest
Messages
11
Best answers
0
I need advice. My facility did a preventative screening Dexa on a patient. It was found that this patient had osteopenia. I coded the claim as Osteopenia rather than using the V screening code. The patient's insurance processed it and accessed a patient portion. The patient was told by the insurance company that they would pay 100% if the claim was recode using the preventative code instead of the diagnosis code. The patient called me and asked me to do so. I called the insurance company and explained the situation and they told me that I could only recode if I filed it incorrectly the first time.

My question is: Did I code the claim correctly by coding osteopenia, even though there wasn't a diagnosis when the patient had the exam?

Thanks for any help you can give me.
 
Dx

I always use the guidelines for signs/symptoms that says to use the definitive diagnosis if found. I also do radiology as you do.
Hope this helps!
 
No it was incorrect since the patient had no signs or symptoms, the guidelines for screening states that the dx code remains screening regardless of the findings. It is true when you are performing a diagnostic study that you may convert from the signs and symptoms to the definitive but screening is different.
 
I agree with Deborah. What is in the coding guidelines in the ICD states is "should a condition be discovered during a screening then the condition may be assigned as an addtional diagnosis". Do not confuse screenings with diagnositics examinations.
 
You must log in or register to reply here.
Top