Wiki E/M Dx. Codes

[bhanson@sunburypc.com]

I have providers that do there out coding but what I am looking to find out is:
A patient is having blood work the dx. code needs to be matched with the blood work but what if the patient recieves a dx. code but doesn't have the problem? ex. Lipids being drawn dx. code 250.00 is matched, patient is not diabetic though... Is this appropriate to do? The patient is then after that being processed with the dx. code 250.00 and does not have this disease. Can someone help me?

 

[mitchellde]

This absolutely NOT appropriate. You may never append a dx code to a claim that the patient does not have. That is using a dx code just to make a clim pay and that is intentional fraud. Also you are giving the patient dx that they do not have but their insurance co thinks they do. This will cause issue for the patient with respect to insurance rates, life insurance, pre-existing conditions. This is so wrong!

 

[bhanson@sunburypc.com]

Thank you for your reply. I thought it was but wanted to make sure before I proceeded.