Medicare Rules for Reporting Diagnosis Codes


Its nice to have a reminder every once in awhile…  🙂


Providers often ask, what diagnoses do we report on a claim – everything the patient has or has had, or just the reason for the encounter?

Report the code that is chiefly responsible for the patient encounter. When other chronic or documented conditions coexist at the time of treatment and affect patient care, include these diagnoses codes also. Do not code suspected diagnoses and always assign codes to the highest level of specificity