Use Diagnosis Coding Conventions to Avoid Denied Claims

Abstract

This article discusses how reporting codes in compliance with International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) guidelines can help physicians and other qualified health care professionals (QHPs) avoid denied claims. This includes the following: How ICD-10-CM codes affect claims adjudication Coding to the highest level of specificity Compliance with Excludes1 notes Compliance with “code first” notes Appropriately reporting codes for sequela Correct use of codes for external causes Proper linking of diagnosis to procedure codes