Neurology & Pain Management Coding Alert

Follow these 4 steps to help avoid audit woes.Picture this: Your neurologist treats a patient who complains of chronic pain. Your neurologist, however, is unable to assign a definitive diagnosis during the visit. You know better than to alter or guess a diagnosis to ensure payment; now learn about appropriate codes that can help you handle the situation.1. Stay Sharp Interpreting DocumentationSpecificity 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 won't be paid for a service due to a Medicare Local Coverage Determination [LCD] or a third-party medical policy," McDermott points [...]