Anesthesia Coding Alert

Be careful not to put words in your physician's mouth, or risk audit woes. Imagine your pain management specialist treats a chronic pain patient, but during the visit your physician isn't able to uncover a definitive diagnosis. While you know that altering or guessing a diagnosis to ensure payment is wrong, there are codes you can choose from to handle the situation. Here's what you need to know. Interpret Doc's Docs for Help Specificity in diagnosis coding is always important, but it is increasingly vital because third-party payers are establishing more stringent coverage criteria for therapies and procedures and are using automated edits to deny claims based on the lack of a covered diagnosis, says Mary H. McDermott, MBA, CPC, with Johns Hopkins University in Baltimore. Using a non-specific diagnosis code, which may be close but not exact, may mean you will not be paid for a service due to [...]