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Thread: Coding question

  1. #1

    Question Coding question

    AAPC: Back to School
    When I was studying in class I was instructed not to use the unspecified codes in the ICD-9 Book. Then I started a job and I noticed that when I do use these codes that they come back denied from the insurance companies.
    Are we to be using these codes or not? I do understand that the ICD-9 book says to use these codes when a more specific diagnosis can not be used. Even when I try to use these codes because I can not find another code to fit it comes back denied. So should you ever use these codes?


  2. #2


    Are you talking about NOS or NEC codes? Both of these types of ICD-9 codes serve a purpose, and are billable codes; however, you should always be coding to the greatest level of specificity so it sounds like you are using them more often then they are intended.

    NEC: There is no separate code for the condition in ICD-9 even though the diagnostic statement may be very specific

    NOS: Used only when neither the diagnostic statement nor the medical records provides information that permits classification to a more specific code

    If you are finding that you are are using many NOS codes, I would talk to the physician and ask that they document to the highest level of specificity.

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