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Frequently Asked Questions
Diagnosis Codes
- Do I add zeros to
my diagnostic code if I don't use all 5 spaces? No,
please copy your diagnostic code exactly as it appears in
the manual.
- I am concerned about
the diagnosis code placing a label on the child. What happens
to these forms once Third Party Billing receives them?
The diagnosis code is used for billing purposes only. After
Third Party Billing receives and processes the encounter
data forms, they are filed.
- How do I select a
diagnosis code? The diagnosis code that is selected
should reflect the reason that you are seeing the child.
In instances where the child qualifies for more than one
diagnosis code, please select the most prevalent condition.
- What should we do
if a child qualifies for several codes? The diagnosis
code that is selected should reflect the reason that you
are seeing the child. In instances where the child qualifies
for more than one diagnosis code, please select the most
prevalent condition.
- What diagnosis code
should I use for a multi-handicapped child? For a child
with multiple handicapping conditions, please use the most
prevalent diagnosis code.
- Can a child qualify
for multiple diagnosis codes? Yes, a child can qualify
for multiple diagnosis codes; however, the diagnosis code
that is selected should reflect the reason that you are
seeing the child. In instances where the child qualifies
for more than one diagnosis code, please select the most
prevalent condition.
- Can the diagnosis
code change? Yes, the diagnosis code can change depending
on who is seeing the child for services. The diagnosis code
that is selected should reflect the reason that you are
seeing the child. In instances where the child qualifies
for more than one diagnosis code, please select the most
prevalent condition.
- Where will we find
the diagnosis code? The diagnosis codes are located
in the back of the Case Management Manual.
- Is the diagnosis code
documented in the child's record? No, the diagnosis
code is not in the child's record. You can find the codes
in the back of the case management manual.
- The diagnosis code
that I used last year is not here. What should I do?
Please call the Office of Third Party Billing at 4130. We
will be happy to help you with your diagnosis code if you
are unable to find one in the back of your Case Management
Training Manual. Medicaid Regulations have changed; some
diagnosis codes now require a fourth or fifth digit.
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