6 Easy Questions to Ask Yourself About Medical Necessity
Published on Mon Jan 04, 2010
Let these answers help keep your diagnosis coding on track. When you're trying to get to the bottom of a diagnosis-based denial, start moving in the right direction by asking yourself these questions recommended by Kelly Dennis, MBA, ACS-AN, CANPC, CHCA, CPC, CPC-I, owner of Perfect Office Solutions in Leesburg, Fla: 1. Is the diagnosis code valid for the date of service billed? 2. Is the diagnosis code limited to being reported as a secondary diagnosis only? 3. Is the diagnosis coded to the highest specificity? 4. Is additional information and/or diagnosis codes necessary? 5. Is the payer denying "unspecified" diagnosis codes? 6. Is the diagnosis code appropriate for the gender and age?