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CodeMap Compliance Briefing: 6/13/03: Diagnosis Coding Rules Continued

Editor's Welcome:

The following discussion of ICD-9 coding rules for clinical laboratories concludes our two week review of ICD-9 coding practices for diagnostic test providers. In case you missed last week's discussion, the briefing explained diagnosis coding rules for pathologists and radiologists. Past CodeMap Compliance Briefings may be accessed by visiting our website. As always please do not hesitate to forward questions, comments, or suggestions for future CodeMap Compliance Briefings.  

Sincerely,

Gregory Root, Esq.

ICD-9 Coding Rules for Clinical Laboratories

Rule 1: Only Submit Diagnoses Obtained from the Ordering Physician

Clinical laboratories should obtain all diagnosis information submitted on claims to Medicare or Medicaid from the ordering physician. Unlike pathologists and radiologists, clinical laboratories may not alter the diagnosis based on the findings of the test or procedure.

Medicare regulations ....

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