Any 3 digit ICD9 code is , it is most commonly referred to as a title diagnosis (a "title" that describes the content of the codes contained within that title (related directly to the numeric sequence). If you reference the ICD9 book you will notice that every code range is lead by a 3 digit code that defines that category of codes to follow. It becomes crystal clear when you compare the structure of the codes to that of a book. The chapter name and number represent the title diagnosis (v22) and the pages represent the codes (v22.0 to v22.2) contained within that chapter.
Some companies will not pay a claim if a title diagnosis code is report as the primary diagnosis. As far as HIPAA is concerned, this practice would still be acceptable so long as you are denying it for a more specific code and not denying for a valid code. According to the HIPAA Code Sets ICD9 is an adopted code set. Any ICD9 code is a valid code as per HIPAA. The ICD9 code book indicates under its "Level of Specificity in Coding" to assign three-digit codes only if there are no four-digit codes within that code category. The bottom line here is that if it is in the ICD9 book it's a valid code as far as HIPAA is concerned. I hope this information will answer at least some of your questions. -----Original Message----- From: Ratterree, Brent [mailto:[EMAIL PROTECTED]] Sent: Wednesday, October 10, 2001 7:21 PM To: [EMAIL PROTECTED] Cc: '[EMAIL PROTECTED]' Subject: RE: I can't believe I'm asking this question Martin, Translating written medical documentation into codes can be both a science and art with room for disagreement. Proper coding guidelines indicate that the diagnosis is appropriate if you follow the ICD-9 manual, i.e., additional digits are required. The issue is that current policies and procedures of providers, payers and etc. do not necessarily edit for or restrict diagnosis codes to proper diagnosis specificity. If your business accepts V22 today and does not want to change, I do not see that as violating HIPAA compliance. HIPAA mandates transaction sets and the code sets within in them. What your business does with or how it validates those code sets is an internal issue. Any contrary opinions? Personally, I would like HIPAA to require all covered entities to follow the code sets' guidelines and edit, as much as possible, for proper coding. [In the V22 example, an edit for 4th digit diagnosis specificity.] In my role as validating claims/encounter data for a government entity I see many "unnecessary" coding specificity errors from providers and payers. Brent Ratterree Encounter Administrator AHCCCS (602) 417-4571 (voice) (602) 417-4725 (fax) [EMAIL PROTECTED] -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]] Sent: Wednesday, October 10, 2001 3:07 PM To: [EMAIL PROTECTED] Subject: I can't believe I'm asking this question I am reluctant to pose this question, but need the validation. Here goes... Is "V22" a HIPAA-compliant diagnosis code? { } Yes, you dummy. It's right there in the book! { }No, It's clearly marked "Additional Digits Required" in the 2001 ICD-9 manual. Martin A. Morrison Project Management Consultant HIPAA <http://aspe.os.dhhs.gov/admnsimp/> Implementation/Coordination Blue Shield of California <http://www.blueshieldca.com/> 4203 Town Center Bl., Ste. D1 El Dorado Hills, Ca 95762 Ph: (916) 350-8808 Fx: (916).350.8623 [EMAIL PROTECTED] <mailto:[EMAIL PROTECTED]> Call me using NetMeeting <callto:[EMAIL PROTECTED]> Add my contact info to your organizer: <http://my.infotriever.com/mmorri> Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. -----Original Message----- From: NTList [mailto:[EMAIL PROTECTED]] Sent: Friday, August 17, 2001 10:43 AM To: [EMAIL PROTECTED] Subject: Welcome to codeset To send a message to all codeset list members, use a message with the following form (the email address is case insensitive): -------------------------------------------------------------- From: Lesley Fisher <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Subject: PROBLEM WITH LOADING PRODUCT Can anybody help me unzip my file? -------------------------------------------------------------- To stop receiving messages from codeset you will need to send a message to the list manager called [EMAIL PROTECTED] For example: -------------------------------------------------------------- From: Lesley Fisher <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Subject: <not needed> <not needed> -------------------------------------------------------------- If you receive a message saying you are not a member but you are still getting messages, you could be subscribed as a different email address. Check for the "X-ListMember:" clause in the header of the message. It will have the form: X-ListMember: [[EMAIL PROTECTED] [EMAIL PROTECTED]] which means that this message was from the list called [EMAIL PROTECTED] and was sent to the email address "[EMAIL PROTECTED]". You can now leave the list by sending the message: -------------------------------------------------------------- From: Lesley Fisher <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Subject: <not needed> leave [EMAIL PROTECTED] -------------------------------------------------------------- If you still have any problems or questions, please email [EMAIL PROTECTED], who will be happy to help.
