Wiki Electronic Billing reporting only 4 diagnosis

mjstack

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Local Chapter Officer
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I am looking for confirmation that insurance companies only review 4 dx codes on any claim because electronic EMRs only transmit (apply) 4 codes per line. I do not believe this to be true, the 5010 1500 has 12 dx code spaces- up to 4 dx pointers per procedure. Anybody? THX [billing thru Athena:( ]
 
Electronic Billing reporting only 4 diagnosis

several years ago when I first started working in coding & billing that was what I was told, but the changes required by insurance payers to capture codes quality care measures changed our concept and we now use up to 12 diagnosis.

Melissa Blankenship
CPC, CPB
 
Changed with 5010

With the change in electronic billing and the 5010 claim requirements back in 2012, the electronic claims became able to hold up to 12 dx codes. This was one of the major reasons behind the 4010 to 5010 implementation with electronic claims.
 
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