Wiki Coder

[ldusek]

Physician Bill's Dx not meeting medical necesdity. Can a coder review and add a Dx clearly noted within the documentation that would meet Medical Necessity allowing claim submission to be clean.
Or would you bill claim out as is knowingly that the Dx will deny the claim to Medical Necessity?
Thank you

 

[mitchellde]

A coder should always code based on the documentation and not the codes the provider selects. They Re not trained coders and often select generic codes just to get the job done.