Robbie is a Certified Coding Associate. Ever since he started working at the facility, it has been his job to assign diagnosis and procedure codes to clinical data based on his review of the documentation in the patients’ records. How might Robbie’s accuracy affect the reimbursements the facility receives from Medicare and Medicaid?
Thank you for the opportunity to help you with your question!
Each different diagnosis has a certain code. For instance, depression would be a separate code from generalized anxiety. Medicare and Medicaid only gives certain amounts for each code, in others words, some codes (that may seem similar) would receive totally different (either more money or less money) than other codes. Although depression and anxiety may be clinically related, they have different diagnosis codes and therefore, different reimbursement amounts from Medicare and Medicaid. Procedure codes also vary - CT scan without contrast and CT scan with contrast have different codes and therefore, different reimbursement amounts. It's necessary to be certain your diagnosis and procedure codes are accurate when submitted to ensure the most reimbursement.
Please let me know if you need any clarification. I'm always happy to answer your questions.
Jun 18th, 2015
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