Birdie625
Networker
I hope I explain this clearly - This is not my area of understanding/knowledge. Scenario in question is:
I saw recently: I 'think' test was for CT scan/brain (I dont recall)
Order said Reason: R/O Stroke / DX = G93.89.
Modified order now showed: Reason R/O Stroke // DX = G93.89 & I63.9....Order re-signed by Dr.
I was told (and thought): Dr re-signed order --- all was good for claim
When I tracked the modified changes, I saw the Rad Scheduler told Dr the G93.89 was 'not on list' and to add dx of "cardiac issue" (which was I63.9...the apparently R/O condition)
I think the final claim (I didn't see) on UB was: Reason = G93.89 // DX = G93.89 / I63.9
This scenario seems wrong to me. I wanted to bring to a supervisor's attention, but wasn't sure which direction to go (Rad dept / Provider / Compliance). And heck, "maybe" Im just over-thinking.
My thinking is the Reason should have been sign/symptoms (of a stroke) / DX same along w/G93.89 …. "unless" the Rad Final Report, then instead of s/s code the final, but if Normal, keep s/s.
I personally think the workflow for the Laboratory / Radiology department charges is flawed. I don't know what suggestions to make and/or how I can help to better such.
Any comments and/or links to search on such would be appreciated. Thanks much. Birdie
I saw recently: I 'think' test was for CT scan/brain (I dont recall)
Order said Reason: R/O Stroke / DX = G93.89.
Modified order now showed: Reason R/O Stroke // DX = G93.89 & I63.9....Order re-signed by Dr.
I was told (and thought): Dr re-signed order --- all was good for claim
When I tracked the modified changes, I saw the Rad Scheduler told Dr the G93.89 was 'not on list' and to add dx of "cardiac issue" (which was I63.9...the apparently R/O condition)
I think the final claim (I didn't see) on UB was: Reason = G93.89 // DX = G93.89 / I63.9
This scenario seems wrong to me. I wanted to bring to a supervisor's attention, but wasn't sure which direction to go (Rad dept / Provider / Compliance). And heck, "maybe" Im just over-thinking.
My thinking is the Reason should have been sign/symptoms (of a stroke) / DX same along w/G93.89 …. "unless" the Rad Final Report, then instead of s/s code the final, but if Normal, keep s/s.
I personally think the workflow for the Laboratory / Radiology department charges is flawed. I don't know what suggestions to make and/or how I can help to better such.
Any comments and/or links to search on such would be appreciated. Thanks much. Birdie