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icd-9 order of diag software

Elizabeth Posted Thu 01st of April, 2010 18:18:03 PM

Does anyone know of a software program the you can input your icd-9 codes and it will put them in the correct order for getting paid?

Melanie Answered Fri 02nd of April, 2010 17:22:52 PM

Im not aware of such a thing to be honest but - generally you would base the nature of the visit/dictation with the primary diagnosis given of that visit.

What format of dictation do your physicians use? SOAP by chance or are they categorized?

Also take into consideration that there are a couple payors out there that may very well have a specific format that must be followed...

Here is an example:
Im in New Hampshire - Jurisdiction 14 for Medicare Part B beneficiaries.

An established Medicare patient comes in for their Routine Colonoscopy. They do not have any family history of polyps, cancer - so the appointment is scheduled as a low-risk visit G0121 - and the primary diagnosis would be V76.51 for screening.

Patient arrives for the procedure - and in the dictation the physician finds a rectal polyp and a colon polyp that require removal by snare technique.

The CPT changes to 45385 - BUT the primary diagnosis is V76.51, then the second diagnosis would be 211.4, and third diagnosis would be 211.3

With our Medicare patients, we have to indicate the reason for the appointment being scheduled to begin with - which means the V code is primary - the findings of that procedure would be secondary - so on and so forth.

That would be an example of something that doesnt follow traditional order of diag-coding.

Always refer to dictation/path reports, documentation of the office visit if its an OV code you are billing, when researching the diags.

To be honest, I dont think I would trust any software when it comes to putting diagnoses in order... Just my humble opinion

SuperCoder Answered Mon 05th of April, 2010 06:23:45 AM

I have'nt heard of this kind of intelligent software. I do remember about the Centerecity software from GE, where an incompatible ICD-9 or modifier code billed with a CPT code (specially-surgical) then it won't allow to get that claim filed to insurance. But it doesn't orders accordingly for getting it paid.
If this kind of software comes in the market then our coders job would be on stake.
:-)

Elizabeth Posted Mon 05th of April, 2010 13:06:24 PM

thank you - I have never heard of it either but the Physican I worl for insist she has heard of it - but I also agree should such a thing exist why have us.

Melanie Answered Tue 06th of April, 2010 15:14:41 PM

claim editing functions would be available with software - but not to scan the dictation and automatically determine the order of diags...

ejones57 - Im curious - what is your position? Are you a CPC? a Certified Biller?

Elizabeth Posted Tue 06th of April, 2010 18:08:56 PM

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