Radiology Coding Alert

Set your sights beyond 724.5 -- sometimes. Your interventional radiologist may be seeing more patients complaining of chronic pain. Trouble arises when you don't see documentation of a definitive diagnosis for 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. Clue In to Why Specificity Matters 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 won't be paid for a service due to a Medicare Local Coverage Determination [LCD] or a third-party medical [...]