Wiki Physician Orders for Lab/Diagnostic Tests

[JJOHN0312]

Billing for facility:

Orders from physician are coming over without a dx or an acceptable 1st listed dx. Facility is providing these services and we cannot code them without clarification. Is it inappropriate or correct coding/billing standards to bill/accept orders for labs/diagnostic tests without a dx. Facility is having us call back to the physicians office and they fax an order with a new or added dx after the service is already rendered. Any help is greatly appreciated! Please send any references you have.

Thank you,

Josie, COC, CPC, CPMA

 

[thomas7331]

This is a little old but it's a good reference from CMS that gives guidelines on how diagnosis codes should be assigned for diagnostic tests:

https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/AB01144.pdf

diagnosis codes, diagnosis coding

 

[JJOHN0312]

physician orders for lab-diagnostic tests

Thank you Thomas! I agree.

I was thinking you really needed to have a signed order with diagnosis prior to the patient rendering of services. I'm pretty sure we would not be able to bill these, wouldn't they be considered retroactive orders??

Josie, COC, CPC, CPMA

diagnosis codes, diagnosis coding