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Medicare Compliance & Reimbursement

PART B ICD-9 CODING:

Stop Asking "Which Diagnosis Code Will Get My Claim Paid?"

Published on Fri Jan 01, 2010

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?" 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, "The entire record should be reviewed to determine the specific reason for the encounter and conditions treated." Keep in mind: "It is illegal to just assign an ICD-9 code that will get your claim paid -- you have [...]
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