Wiki diagnosis reported in error

[laura vangroningen]

Hi,
If a provider misdiagnosed a patient and the charges were already reported and paid by the insurance carrier before the misdiagnosis was discovered, is it a requirement to submit a corrected billing to the insurance carrier for the purpose of updating the diagnosis code for their records? Where can I find what the requirements for documenting in the patients medical record when an error like this is reported?

Thank you in advance for your direction,
Laura

 

[eswaranpandiyaraj]

Missed diagnosis

Hi ,
It is look like up coding because there is not any document in medical record we should not code and bill. For this case you should update the correct Diagnosis code to that claim when you got denial like. Documentation lacks the necessary provider order that time you should ask provider and add diagnosis to the claim (N455).


If any questions please let me know.

Thanks and regards,
Eswaran .P

Hi,
If a provider misdiagnosed a patient and the charges were already reported and paid by the insurance carrier before the misdiagnosis was discovered, is it a requirement to submit a corrected billing to the insurance carrier for the purpose of updating the diagnosis code for their records? Where can I find what the requirements for documenting in the patients medical record when an error like this is reported?

Thank you in advance for your direction,
Laura