That's difficult when you don't know the Chief Complaint or access to the chart/doctor.
Look through the most current ICD-9 Coding Guidelines and it can explain when a sign or symptom is used vs. a more definitive diagnosis or a final diagnosis. It's about 112 pages and it has great information on diagnosis coding.
You should educate that office to let them know that either having the doctor's prioritize their diagnoses before you get the charges or you need to have access to the record to ensure approrpiate ICD-9 code choice is made.
Good Luck, Eddie!
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