One of our billers (in a neurology office) is notifying me that, because the reason for the procedure was listed under different icd-10-cm codes, the encounter for the procedure should get those other diagnoses codes instead of the one that's usually used, which is S06.0x0a. Unfortunately, the providers use a template to fill out the diagnoses, the codes (CPT and ICD-10-CM) in the charge entry space, and most of the procedure documentation and only making changes when changes are needed. I've stated to said biller that I can only code the diagnoses based on what is in that particular documentation, not using previous encounters. And the diagnosis for the EEG procedure is Concussion without loss of consciousness S06.0x0a. I have since discovered that the provider locked/signed the previous encounter before I could check the order of the diagnoses codes and I didn't notice it since he did that overnight.
Was I supposed to use the other diagnoses codes instead of the sole diagnosis + code which was used on the EEG encounter's documentation? This is the first time I've seen this type of denial, so any advice/thoughts would be greatly appreciated!
Was I supposed to use the other diagnoses codes instead of the sole diagnosis + code which was used on the EEG encounter's documentation? This is the first time I've seen this type of denial, so any advice/thoughts would be greatly appreciated!
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