If a provider links diagnosis codes to each laboratory test, does the certified coder in the lab have the ability to change the diagnosis codes to meet medical necessity requirements?
Ex: CBC - 401.9 (HTN)
Lipid Panel - 780.79 (Fatigue)
The office note shows both diagnoses in the diagnosis section, however, under the treatment section the information shows:
1. Hypertension:
CBC
2. Fatigue:
Lipid Panel
I am being asked to bill the Lipid Panel with 401.9 (meets medical necessity) instead of 780.79 (does not meet medical necessity) and don't feel it is correct to do so since the medical record does not reflect this linkage. Currently I am sending a querry to the ordering provider. Any thoughts or supporting documentation on what would be the most appropriate way to handle this is appreciated!
Thanks!
Ex: CBC - 401.9 (HTN)
Lipid Panel - 780.79 (Fatigue)
The office note shows both diagnoses in the diagnosis section, however, under the treatment section the information shows:
1. Hypertension:
CBC
2. Fatigue:
Lipid Panel
I am being asked to bill the Lipid Panel with 401.9 (meets medical necessity) instead of 780.79 (does not meet medical necessity) and don't feel it is correct to do so since the medical record does not reflect this linkage. Currently I am sending a querry to the ordering provider. Any thoughts or supporting documentation on what would be the most appropriate way to handle this is appreciated!
Thanks!