Wiki Excessive diagnoses and linking

[AuditU]

Good afternoon!
Help please - for the sake of the question assume that all documentation/medical necessity criteria, etc. has been met.

If a provider sees a patient and documents 15 diagnoses and wants to electronically submit all diagnoses to Medicare - how would you link the extra diagnoses to a CPT code? I know you would not submit an office visit x2 - for example 99213 - linking a certain number of DX's and 99213 linking the rest. What CPT code and/or dummy code would you use to link the extra DX's?

Thank you

 

[mitchellde]

You may report a total of 12 diagnosis per claim. You may link only four to a line item. You may not have more than 12 DX codes for a single claim. If you try to submit a second page you will wind up with two "a" (first listed) codes, so the one on page two will over ride the one on page one. You cannot list a CPT code twice just to be able to link more dx codes. You link the most pertinent 4 diagnosis for the service provided. If most of these are chronic on going issues with just med refills then consider those to be last. Most important are the the reason for the encounter and any others that require additional attention, further work up, or are conditions that complicatie the treatment of the reason for the encounter.