Wiki Diagnosis Pointers

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KaitlynEFitch

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I am new to all of this.. but I hear that there are only 4 diagnosis pointers per claim, whether it be paper or electronically sent.
But what happens when my doctor does 5 different excisions and each excision comes back as a different diagnosis? Would I only put 4 on one claim and split the other on another?

Thank you. <3
 
look at your claim form, field 21 is the diagnosis code field, you may list a maximum of 12 diagnosis codes per claim.
Field 24 is the procedures field per procedure you may link only 4 dx codes, but any 4 of the 12.
so you have diagnosis codes
a_______ d_________ g________ j_________
b_______ e_________ h________ k_________
c________ f_________ i_________ l_________

then in filed 24
date POS Procedure modifier diagnosis
1/31/14 11 99214 25 a,b,c,d
1/31/14 11 20605 50 a,b


I hope that makes sense
also you can go to NUCC.org and download the 1500 manual which will detail this for you
 
So I should put 4 diagnosis on one claim and put the others on another? I would have to split the procedures up, too since there are only 4 diagnoses for 6 procedure lines.
Would the claim be denied for being split up on a same date of service being sent electronically together?
 
Your claim has room for 12 dx codes, the 5010 electronic was fixed this wa Jan of 2012 and the paerform went live Jan 6 2012.
You cannot split the dx codes on two claims. The #1 dx code is always the #1 the second claim will be a duplicate claim for that date of service.\
you put 12 dx codes on the claim as I illustrated above, you can point 4 to a single line item,
if you have 3 procedure codes each one can have 4 different dx codes linked, all on the same claim.
look at the claim at this link
http://nucc.org/\images\stories\PDF\1500_claim_form_2012_02.pdf
 
Is this for electronically sending, also? The computer system that I use only lets me put 8 diagnoses when I am entering them into the computer.
 
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