Medicare Compliance & Reimbursement

Instead, code directly from the medical record. Medical coders face a lot of questions each day in the course of their work, but one question you should not be asking is, "which diagnosis code should I put on this claim if I want to collect?" When Eli solicited subscribers' questions, the overwhelming majority asked questions such as, "We performed xyz procedure -- can you tell me which diagnosis codes we can report to Medicare to get this claim paid?" But this type of ICD-9 coding is backward, experts say. Instead, you should be coding based on the documentation -- not based on which codes your Medicare Administrative contractor (MAC) will reimburse. "I do not feel that we as coders should be coding based on getting the claim paid," says Michelle Jubeck, CPC, CEMC, CPMA, coding compliance analyst with Monroe Clinic in Monroe, Wis. Jubeck points to the ICD- 9-CM guidelines, which state, [...]