Posted in ICD-10 & Coding

Medical coders are not diagnosticians

Carl Natale
by Carl Natale
Medical coders are not diagnosticians

question from the ICD-10-CM Coding Guidelines came up in the AAPC ICD-10 Forum recently. Someone asked for help with this statement:

"The assignment of a diagnosis code is based on the provider’s diagnostic statement that the condition exists. The provider’s statement that the patient has a particular condition is sufficient. Code assignment is not based on clinical criteria used by the provider to establish the diagnosis."

Basically, the coders do not interpret the clinical notes and assign the diagnosis codes based upon notes. Physicians make the diagnoses.

This is a weekly feature that I use to highlight practical tips on how to use and understand ICD-10-CM/PCS codes. Please let me know of any other sources that I can include.