• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Question Can the CPC change the Primary Dx on the claim, (not the notes)?

Create Wiki Sort by votes
S

Suebenda1958

New
Messages
3
Location
Blanchard, OK
Best answers
0
The provider listed PDX and SDX as DM and HTN, which he then said "stable under current regime". Then in the HPI it says the patient was here for shoulder pain and needing referral to a surgeon for a hernia repair. I feel it should be coded with the hernia and shoulder pain as PDX and SDX and then DM and HTN. Could someone help me with this please?
 
0
That is generally hospital or practice specific. You would never change a diagnosis in a hospital inpatient setting because it could impact the DRG payment. You can query the provider, but you have to do so compliantly. If all four diags are going onto the E&M visit on the claim form, then there won't be any payment issue. I would check with your providers to get permission to recode their claims before you do so.
 
You must log in or register to reply here.
Top