Acceptable ICD codes as Prinicapl Diagnosis ONLY

[Shurafa2018]

Dears,

I want to know if there are ICD10 codes that only acceptable as Principal diagnosis, if yes please send me the ranges and the guidelines.

Thank you

 

[Chelle-Lynn]

I would recommend that you access the ICD-10 Official Guidelines for Coding and Reporting for FY 2018 or FY 2019 as appropriate. This can be located in your ICD-10 book or the link is below if you would prefer a larger copy. These guidelines will help with sequencing and always code as primary, etc information. It is very helpful.

https://www.cms.gov/Medicare/Coding/ICD10/Downloads/2019-ICD10-Coding-Guidelines-.pdf

 

[Shurafa2018]

Thank you for your reply.

I have one more question about this case, what is the difference between principal diagnosis and first-listed diagnosis? Because in the guidelines they are using both. Is the principal diagnosis used for outpatient and first-listed diagnosis for inpatient ?

Thanks.

 

[mitchellde]

Principal Diagnosis is a term used mostly in the inpatient setting for facility coding an inpatient facility claim uses a POA code (present on Admission) as well as a principal diagnosis. The first-listed diagnosis is a term that mostly applies to the CMS 1500 claim form used mainly for physician billing. The 1500 has the possibility for 12 diagnosis codes on the claim, the most important one being the one that is first-listed. Some codes are first-listed only allowed but not allowed as a principal diagnosis. So in the code book where it indicates not principal diagnosis allowed, that applies primarily to the inpatient facility coding while first listed only applies mainly to the physician claim. for instance Z00.00 is first-listed only allowed but is not allowed as a principal diagnosis.

diagnosis codes, diagnosis coding