Wiki How many Dx codes can be liked to 1 CPT code

[debneas]

I know the number of diagnosis codes on a claim is now 12, but how many can be linked to one CPT code?

 

[mitchellde]

Maximum linkage is 4 codes, any 4 of the 12 listed but still only four per line item.

 

[debneas]

Will this change with ICD-10? We are in Dermatology and many patient's have more then 4 dx linked to an OV.

 

[mitchellde]

No somfar it is still 4 codes per line item, if you have more than 4 you link the most pertinent 4.

 

[deepabbhatt]

can someone explain about how to link diagnosis code with cpt codes

 

[SharonCollachi]

can someone explain about how to link diagnosis code with cpt codes

In your billing software, there will be a place to link them together.

 

[TThivierge]

Hi
Ensure your diagnosis codes are linked properly but also with regards of sequencing and Excludes Rules 1. Also it should be linked due to the medical necessity factor. The CMS 1500 claim has 12 dx codes, but guess the insurance payers only want to see the first 4 dx. The inpatient billing UB92 has about 20 dx codes can be listed per severity of the illness.
I hope this helps you
Lady T

 

[SharonCollachi]

The CMS 1500 claim has 12 dx codes, but guess the insurance payers only want to see the first 4 dx.

That isn't what that means. HCFA1500 had places for four dx. If you had up to four dx for everything that happened in one day, you were fine. But if line one needed dx 1,2,3 and line two needed dx 1,4,5 then line two had to go on a separate claim because there was no room for dx 5.

Now those claim lines can all go on one HCFA, because there are twelve places for DX, not just four. Doesn't mean you can assign more than four to one claim line, so that has not changed.

 

[TThivierge]

Hi Sharon
Well each claim line with each CPT code on the CMS 1500 pulls 4 dx codes. Thank you for explaining that each claim line pulls 4 dx codes. but can have up to 12 dx claims.
Lady T