Wiki PROFESSIONAL Radiology Diagnosis Coding

[tmckinney20]

For the coding/billing of the professional claims for radiology coding, are uncertain diagnoses allowed to be coded? The guidelines state 'inpatient' can code uncertain diagnoses. Is this the same for the professional billing of rad claims with a place of service 21? I am finding conflicting information and just need a source of truth. Thanks for your help!

 

[Papitha]

Place of service 21 signifies that it is an inpatient service.

The uncertain diagnoses are allowed to code for the inpatient services. These should not be coded for the outpatient settings. Please find below the reference.


Link - https://pmc.ncbi.nlm.nih.gov/articles/PMC11430383/

Hope this helps!