Wiki Medicare - cardiology practice

[Kathy B.]

I recently joined a cardiology practice. The biller said that I should only bill ONE diagnosis code for any office visit or procedure as this was part of the new rules. However, I researched this on the CMS website, and, as of 6/2011, it states to use up to 4 diagnosis codes. Any assistance in this regard is appreciated.

 

[Kristy]

I've been working for a cardiologist for over 2 years and have never heard this! I'll do some checking but if you hear anything else, could you let me know? thanks

 

[Sage123]

Code it as it's documented. You are a coder not a biller or follow up. Smart woman by researching the CMS website. Watch your billers, sometimes they know things and some times they think they know it all! If your wrong I'm sure He/she will tell you. Better to be wrong and code it right the first time. Good Luck!

 

[HEATHERLEESON]

I am new to cardiology as well but I have not read anything regarding that.
I code as it is documented and office visits are the one thing that I dont have any problems with.

H Hall, CPC

 

[bmx1616]

I'm certain that isn't correct. Some diseases/complications require two diagnosis codes to be coded correctly.

 

[theresa.dix@tennova.com]

I'm certain that isn't correct. Some diseases/complications require two diagnosis codes to be coded correctly.

I am not aware of a rule that states this. But it used to be you could bill up to as many as 8 dx codes per Medicare claim. As far as I know this is the same. When ICD 10 comes around that will increase. Is this the office rule maybe?

 

[RebeccaWoodward*]

Maybe BMX is referring to ICD-9 codes such as (example only) 731 series. The instructions in italicized text instructs you to "code first underlying diseased, if known, such as..."

or-

ICD-9 code 785.52 has a statement that instructs you to "code first: systemic inflammatory response syndrome due to....."

I come across these from time to time...