So I went to a workshop and the presenter stated the dx code description overrides the code itself, I cant find in the guidelines where it states this? anyone know where I can find info on this?
Amy
Amy
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Wiki dx description vs code
- Thread starter awinters1000
- Start date
mitchellde
True Blue
you cannot find it because it is an untrue statement.
Take the example of a diabetic patient with charcots disease. This was coded as A52.16 which has the descriptor of Charcots arthropathy. The problem is it is the wrong code in a big big way.. This is a code for a disease due to syphilis. Diabetic (type 2) charcots disease is coded as E11.610 which has the descriptor of Type 2 diabetes mellitus with diabetic neuropathic arthropathy. while the descriptor does not state charcots arthropathy it is the correct code.
If you look closely at the A52.16 it states .. Charcôt's arthropathy (tabetic) The tabetic means due to syphyilis.
This has happened to a family member and the provider office is telling her the same thing you were told.. the descriptor is correct so the code is correct. You see how this is just not true! It is hold up her disability claim. You must look at the whole code structure not just the single code descriptor. If the category is incorrect for your diagnosis then the code in the category is incorrect.
Take the example of a diabetic patient with charcots disease. This was coded as A52.16 which has the descriptor of Charcots arthropathy. The problem is it is the wrong code in a big big way.. This is a code for a disease due to syphilis. Diabetic (type 2) charcots disease is coded as E11.610 which has the descriptor of Type 2 diabetes mellitus with diabetic neuropathic arthropathy. while the descriptor does not state charcots arthropathy it is the correct code.
If you look closely at the A52.16 it states .. Charcôt's arthropathy (tabetic) The tabetic means due to syphyilis.
This has happened to a family member and the provider office is telling her the same thing you were told.. the descriptor is correct so the code is correct. You see how this is just not true! It is hold up her disability claim. You must look at the whole code structure not just the single code descriptor. If the category is incorrect for your diagnosis then the code in the category is incorrect.
mitchellde
True Blue
You have a problem in your database. this is what happens when you allow persons to go into the data base and "customize code descriptions. Now you have multiple descriptions and several are completely incorrect so when a provider selects this code they really have no idea what this code actual represents. I don't know how to tell you to fix this but clearly you cannot rely on the codes selected by the physicians.
Pathos
True Blue
Get your IT department involved with the following suggestions:
1) Start from a clean slate and remove ALL custom code descriptions. Only have a select few (if any) access to make custom code descriptions. Might cause billing disruptions depending on the software.
2a) Manually check every single diagnosis code. 2b) Better yet, filter for any custom code descriptions (if available) and look at each code to ensure correctness. This is really tedious, but might work better than 1).
I recommend something done about this, since your providers might unknowingly select incorrect codes due to wrong descriptors. Outside lost revenue, this could likely affect patient's benefits as well.
1) Start from a clean slate and remove ALL custom code descriptions. Only have a select few (if any) access to make custom code descriptions. Might cause billing disruptions depending on the software.
2a) Manually check every single diagnosis code. 2b) Better yet, filter for any custom code descriptions (if available) and look at each code to ensure correctness. This is really tedious, but might work better than 1).
I recommend something done about this, since your providers might unknowingly select incorrect codes due to wrong descriptors. Outside lost revenue, this could likely affect patient's benefits as well.