codegirl0422
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Please help,
How do you get dx V76.51 as the primary dx when you do not key it with a procedure code. Based on Medicare's guidelines, you are to only use 2 in the dx pointer next to the polyp removal. Any help with posting the charge would be greatly appreciated. My software does not let me put in a dx without keying a procedure first and I have sent the explanation to the software's help desk and they can't seem to figure it out. Right now, I key the charge with V76.51 first and 211.3 2nd and it pays ok, but it is not billed according to Medicare guidelines.
Thanks a bunch for any help
“CMS advises that, whether or not an abnormality is found, if a service to a Medicare beneficiary starts out as a screening examination (colonoscopy or sigmoidoscopy), then the primary diagnosis should be indicated on the form CMS-1500 (or its electronic equivalent) using the ICD-9 code for the screening examination.
Item 21 (Diagnosis or Nature of Illness or Injury)
Indicate the Primary Diagnosis using the International Classification of Diseases, Ninth Revision, Clinical Modification, (ICD-9-CM) code for the screening examination (colonoscopy or sigmoidoscopy), and
Indicate the Secondary Diagnosis using the ICD-9-CM code for the abnormal finding (polyp, etc.).
Item 24E (Diagnosis Pointer)
Enter only "2" (to link the procedure (polypectomy or biopsy) with the abnormal finding (polyp, etc.)”
How do you get dx V76.51 as the primary dx when you do not key it with a procedure code. Based on Medicare's guidelines, you are to only use 2 in the dx pointer next to the polyp removal. Any help with posting the charge would be greatly appreciated. My software does not let me put in a dx without keying a procedure first and I have sent the explanation to the software's help desk and they can't seem to figure it out. Right now, I key the charge with V76.51 first and 211.3 2nd and it pays ok, but it is not billed according to Medicare guidelines.
Thanks a bunch for any help
“CMS advises that, whether or not an abnormality is found, if a service to a Medicare beneficiary starts out as a screening examination (colonoscopy or sigmoidoscopy), then the primary diagnosis should be indicated on the form CMS-1500 (or its electronic equivalent) using the ICD-9 code for the screening examination.
Item 21 (Diagnosis or Nature of Illness or Injury)
Indicate the Primary Diagnosis using the International Classification of Diseases, Ninth Revision, Clinical Modification, (ICD-9-CM) code for the screening examination (colonoscopy or sigmoidoscopy), and
Indicate the Secondary Diagnosis using the ICD-9-CM code for the abnormal finding (polyp, etc.).
Item 24E (Diagnosis Pointer)
Enter only "2" (to link the procedure (polypectomy or biopsy) with the abnormal finding (polyp, etc.)”