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More than 4 dx codes

  1. Post More than 4 dx codes
    Medical Coding Books
    How do you handle the claims when you get more than 4 diagnostic codes? The doctor has listed 7 to 8 diagnostic codes and wants to make sure they are all in the claim.

    Do you split it into 2 or 3 claims?? Help!

  2. #2
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    Quote Originally Posted by esanmiguel View Post
    How do you handle the claims when you get more than 4 diagnostic codes? The doctor has listed 7 to 8 diagnostic codes and wants to make sure they are all in the claim.

    Do you split it into 2 or 3 claims?? Help!
    I've had this issue come up where I work but I'm not sure if it is the same capacity as you. Example a pt is seen for a office visit and labs, there could be 4 dx to go with the visit and then the other 3 or 4 go with the labs. I will split the ticket and bill the office visit and then bill the labs separate.

    Hope this helps.
    Roxanne Thames CPC, CPC-I, CEMC
    rthamescpci@gmail.com


    "Remember the greatest gift is not found in the store but in the heart of true friends"

  3. Default
    Quote Originally Posted by rthames052006 View Post
    I've had this issue come up where I work but I'm not sure if it is the same capacity as you. Example a pt is seen for a office visit and labs, there could be 4 dx to go with the visit and then the other 3 or 4 go with the labs. I will split the ticket and bill the office visit and then bill the labs separate.

    Hope this helps.
    Thank you - i should have posted an example:

    One of the claims has:

    738.4 acquired spondylolisthesis
    840.8 shoulder sprain
    847.1 thoracic sprain
    847.0 cervical sprain
    784.0 headache
    739.1 subluxation 4 levels
    728.4 laxity of ligament
    738.2 acquired deformity of neck

    Then procedure 97014 electrical stimulation, for example, applies to at least 5 of these.

  4. #4
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    Medicare accepts up to 8 ICD-9 codes per claim.

    I am guessing this is a system limitation you are dealing with? If you are submitting claims electronically I would speak with the software vendor if the system doesn't allow for more than 4.

    Not sure on paper claims, I haven't dealt with paper claims since '99.

    Laura, CPC

  5. #5
    Location
    Columbia, MO
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    Laura is correct that was one of the chages for the new 1500 form so you need to talk to your vendor as you should be able to input 8 electronically.

    Debra Mitchell, MSPH, CPC-H

  6. #6
    Location
    Lauderdale Lakes, FL
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    19
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    Yep.. 8 is the new "4".

    However, not only does your software have to be able to handle it, your clearinghouse has to be able to pick it up and transmit it.

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