Radiology Coding Alert
Dont Code Rule-out
Alabama Subscriber
Answer: Payers do not accept a rule-out diagnosis. In cases like this, you should return to the physician who ordered the MRI to establish which signs or symptoms prompted him or her to suspect a torn rotator cuff. Many signs and symptoms are considered payable by Medicare.
In addition, a review of the physicians office notes, if available, should give you some idea why the patient was seen and what the complaint was. You should find that these include shoulder pain (719.41, other and unspecified disorders of joint; pain in joint; shoulder region), parasthesia (782.x, symptoms involving skin and other integumentary tissue) or something similar. You should use this information to determine the diagnosis code and avoid reporting the rotator cuff tear.
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