Current through Register Vol. 50, No. 9, September 20, 2024
A. Diagnosis
Coding. The International Classification of Diseases, Tenth
Revision (ICD-10-CM) is the basis of diagnosis coding. These are the
disease codes in the international classification, tenth revision, clinical
modifications published by the U.S. Department of Health and Human
Resources.
B. Helpful Hints for
Diagnosis Coding
1. To ensure accurate
payment, always report the primary diagnosis code on the claim form.
2. Each diagnosis code should be reported
when services for multiple diagnosis are filed on the same claim
form.
3. All digits of the
appropriate ICD-10-CM code(s) should be reported.
4. The date of accident should always be
reported if the ICD-10-CM code is for an accident diagnosis.
5. It is important to provide a complete
description of the diagnosis if an appropriate ICD-10-CM code cannot be
located.
C. Procedure
Codes. HCPCS (pronounced "hick picks") is the acronym for the HCFA (Health Care
Financing Administration) common coding system. This system is a uniform method
for health care providers and medical suppliers to code professional services,
procedures and supplies. HCPCS contains three unique coding systems, each
called a level and numbered I, II and III respectively.
1. Level I. Level I is the American Medical
Association's CPT (Physicians' Current Procedural Terminology) which is
developed and maintained by the AMA. The CPT is a listing of descriptive terms
and identifying codes for reporting medical services and procedures performed
by physicians and are used for processing claims. Each procedure or service is
identified with a five digit code.
2. Level II. HCPCS National Level II codes
are alphanumeric codes which start with a letter followed by four numbers.
These codes can be used in addition to CPT codes when services are provided at
the same time or during the same visit. All services, procedures, supplies,
materials and injections should be properly documented in the medical
record.
3. Level III. This level is
often used to describe new services, supplies or materials or to report
procedures and services which have been deleted from CPT. These level III codes
are not to be used for Workers' Compensation claims.
NOTE: The following Sections are to be used for Chapter 51
only.
AUTHORITY NOTE:
Promulgated in accordance with
R.S.
23:1034.2.
