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Thread: Need Clarification Please!

  1. #1

    Default Need Clarification Please!

    AAPC: Back to School
    Am currently performing an audit on pro fee behavorial health visits. The physicians are billing daily visits and I need to clarify diagnosis reporting. I understand the facility can use probable, suspected, and likely diagnoses but doesn't the physician for his pro fee charges need to follow other guidelines. I believe the signs, symptoms, etc. would be used as the diagnosis when the overall diagnosis is uncertain at that time of service. Am I correct on this?

  2. #2


    You can code probable, suspected, possibles if you are coding inpatient. If it is outpatient, you can code signs and symptoms or actual dx's. Not sure if that helps you?

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