Hospitalist Group: How many diagnosis codes would you list?

krystle8402

Networker
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73
Location
Canton, IL
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I work for a hospitalist group. I have learned that you list as many diagnosis codes as needed when billing. So if the hospitalist documents 1 diagnosis, I would list that. If he/she addresses 10, even though it's many, I will list all of those (unless a specialist is also using that dx code for the same DOS). Now, if one of the notes has 20 diagnosis, I don't list all 20, but I try to capture as much as I can. I was told that MCR and most commercial insurances only need 1-4 diagnosis codes. I am doing some research, but does anyone know if that's the case?
 
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Everett, WA
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I would list an unlimited number of relevant diagnoses. Even if a payer only needs one to pay a claim, we need to list all of them. CMS is not currently scrutinizing the accuracy of ICD 10 coding but the quality and accuracy of "data" is important for the tracking of disease and mortality.

From https://www.cms.gov/medicare/coding/icd10/downloads/2016-icd-10-cm-guidelines.pdf page 103

"Code all documented conditions that coexist at the time of the encounter/visit, and require or affect patient care treatment or management."
 

krystle8402

Networker
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Canton, IL
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Thank you! I have been listing as many diagnosis as possible, but when I heard it mentioned about carriers only accepting a certain number of diagnosis codes, it made me question if I was listing "too many". Thank for your the CMS reference as well!
 
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