I am an auditor in a family clinic and my billing department has informed me that medicare is not only not paying claims with too many icd9 codes, but is charging us to process them. This just started with 2009 claims. The charges range from $3 to $30. These are all related to one provider. This provider's documentation actually supports the number of diagnosis, i.e. Ordering tests, rx'ing meds, etc. According to icd9 guidelines "code all documented conditions that affect patient care" makes it difficult for the auditors to justify questioning the provider for too many pov's. Now we have justification with medicare not paying the claims, but how do we reconcile this with the icd9 guidelines. Ask the provider to limit the number of issues they deal with at each visit? If anyone has any input to this issue or has encountered this problem, i'd appreciate hearing from you.