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Resolving of diagnoses

  • 02 Sep 2016 8:27 AM
    Reply # 4224135 on 4222950
    RHIT Administrator (Administrator)

    It depends on the payor source as to frequency.  If on Medicare (or insurance) benefits, codes must be resolved when the condition resolves and is no longer being monitored, evaluated, assessed or treated.  Codes cannot placed on claims when the condition is resolved.  So these should be resolved with Triple Check or no less frequently than monthly prior to the next billing cycle.

    For all other payor sources, resolving quarterly after the care conference and the care plan update is appropriate.  Some facilities resolve daily based on telephone orders.

  • 01 Sep 2016 9:09 PM
    Message # 4222950
    Deleted user

    Would someone please share how they resolve diagnoses, i.e. quarterly, physician documentation only.   Do you query the physician if physician documentation is not located but medication is no longer given for the infection.  Please advise.



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