Why is diagnosis (ICD-9 codes) essential for regulatory and reimbursement purposes when ordering diagnostic procedures or services such as Diagnostic Imaging or Laboratory services?Because government and non-government payers depend on diagnoses codes to determine payment for diagnostic services. Medicare also reviews ICD-9 codes to ensure diagnostic services are consistent with National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs) that ultimately define reimbursement practices. The diagnostic information should be specific and pertinent to the diagnostic services ordered. | |
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