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Coding question

  1. Question Coding question
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    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. Default
    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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