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That's to ensure that the service provided (procedure code) matches the diagnosis. For example, the procedure (HCPCS) code "71045" corresponds with the procedu
by baishtar 3y ago
That's to ensure that the service provided (procedure code) matches the diagnosis.
For example, the procedure (HCPCS) code "71045" corresponds with the procedure "RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEW" for billing purposes.
If you were to match that up with the diagnosis code (ICD10) S80.211 for "Abrasion, right knee" there would be a mismatch between the diagnosis and the procedure. This happens all the time due to human error and often results in insurance denials, which sadly take a long time to fix since now you have to get MORE HUMANS involved.