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Wiki Priority Health Unspecified DX Denials
- Thread starter ttompsett
- Start date
TThivierge
True Blue
Hi Ttompsett,
Yes I see it when given a unspecific dx code to process& poor notations. Encoder edit comes up with message this is unspecified may get denied and medical necessity questionable. I believe only way to get around is get clinical providers more education in documenting and insure coders are aware of searching for details in documentation . Some disease & symptoms come in differ levels or stages such as : DM, Cardiac Heart, Depression, HTN,CHKD, Sinusitis, Coughs, Stomach pain, type of Pain, Hemorrhoids, Dementia just to name a few. And not listing the laterality side of organ or limb is REALLY irritating when doing clinical abstractions as a medical coder.
Anyway hope you have a good week.
Lady T
Yes I see it when given a unspecific dx code to process& poor notations. Encoder edit comes up with message this is unspecified may get denied and medical necessity questionable. I believe only way to get around is get clinical providers more education in documenting and insure coders are aware of searching for details in documentation . Some disease & symptoms come in differ levels or stages such as : DM, Cardiac Heart, Depression, HTN,CHKD, Sinusitis, Coughs, Stomach pain, type of Pain, Hemorrhoids, Dementia just to name a few. And not listing the laterality side of organ or limb is REALLY irritating when doing clinical abstractions as a medical coder.
Anyway hope you have a good week.
Lady T