"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." — ICD-10-CM guideline I.A. 19

This guideline is frequently cited as the reason coders list diagnoses because the doctor said so. But is the doctor’s say-so enough? Reporting on this recurring issue during the next edition of Talk-Ten-Tuesdays will be broadcast co-host Erica Remer, MD, founder and president of Erica Remer, MD, Incorporated.

Other segments to be featured on the broadcast include:

• Coding Report: It’s the flu season in the United States, with most activity expected to peak between now and February. Nationally recognized coding authority Laurie Johnson, senior healthcare consultant at Revenue Cycle Solutions, LLC, will be reporting on this developing story.
• News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk-Ten-Tuesdays News Desk.
• HIM Report: Julie Dooling, American Health Information Management Association (AHIMA) director of Health Information Management (HIM) Practice Excellence, will report on the Government Accountability Office (GAO) investigation of the different approaches being used and challenges being faced by hospitals seeking to achieve accurate patient matching.
• Tuesday Focus: CMS Advanced Practitioner Professional (NPP) Billing: Many providers are still struggling with the NPP billing rules from the Centers for Medicare & Medicaid Services (CMS). Author and educator Deborah Grider, senior healthcare consultant for Karen Zupko and Associates, will report on the need for greater understanding of this complex issue.