Part B Insider (Multispecialty) Coding Alert

Make Docs Say TIA When They Mean TIA

If you don't encourage physicians to write the correct terminology in their records, you can face time-consuming denials for medically necessary services.

For example: Physicians sometimes use "cerebral ischemia" as an interchangeable term with "transient ischemic attack" (TIA), but the two are very different in coding terms, says consultant Jackie Miller with Dallas, GA-based Coding Strategies Inc. Coders will translate cerebral ischemia to ICD-9 code 437.1 (Other generalized ischemic vascular disease) and convert TIA to a more specific ICD-9 code, 435.9 (Unspecified transient cerebral ischemia). Medicare will pay for some treatments with 435.9 but not with 437.1.