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rule out dx

  1. #1
    Default rule out dx
    Medical Coding Books
    In a hospital setting when a dr. does surgery on a patient can he use a rule out code as his diagnosis. Example dr. codes pt with Brain Neoplasm But patient has a brain parenchyma no malignancy identified after pathology. But the surgery was already billed with the 191.1 Is it ok to bill rule out DX and if not when can you bill rule out Diagnosis and what to do in this case.


  2. #2
    Columbia, MO
    There are no codes for rule out and a dx not confirmed should never be coded. This is stated in the coding guidelines. This case already billed needs to be corrected. You can use a V71.1 first listed for observation for suspected malignant neoplasm not found and the code the confirm dx secondary. There is never any case where a dx documented as rule put can be coded except by facility coders on the inpatient side, this does not include physician coders when coding inpatients.
    Last edited by mitchellde; 10-21-2014 at 02:23 PM.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    I have always held my surgery claims til the path report comes in.
    Teresa Kelley, CPC
    Detroit, MI AAPC Chapter member

  4. #4
    thank You for your the information. It helped alot

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