Please find the following link and attachments re: ICD-10 Guidelines and conversion of ICD-9 to ICD-10 cross-talk provided by Dr. Elaine Armantrout. As always, Elaine…great work! If anyone reads anything different in the interpretation, please reply accordingly.
Diagnostic Coding and Reporting Guidelines for Outpatient Services
- Patients receiving diagnostic services only
For patients receiving diagnostic services only during an encounter/visit, sequence first the diagnosis, condition, problem, or other reason for encounter/visit shown in the medical record to be chiefly responsible for the outpatient services provided during the encounter/visit. Codes for other diagnoses (e.g., chronic conditions) may be sequenced as additional diagnoses.
For outpatient encounters for diagnostic tests that have been interpreted by a physician, and the final report is available at the time of coding, code any confirmed or definitive diagnosis(es) documented in the interpretation. Do not code related signs and symptoms as additional diagnoses.
Please note: This differs from the coding practice in the hospital inpatient setting regarding abnormal findings on test results.
My read on this CMS guideline is that because NCS/EMG studies are not by themselves diagnostic, I am not interpreting the NCS/EMG test results to determine the definitive diagnosis. Therefore, my plan is to list the referring provider’s ICD-10 code as the first diagnostic code and then list any additional diagnostic codes relating to the patient’s comorbidities and signs & symptoms.
Elaine Armantrout, PT, DSc, ECS