With the adoption of ICD-10-CM code set, we were introduced to diagnosis codes that now indicate the laterality of a condition.  At present, diagnosis code descriptions indicate whether the condition is present on the left, right or exists bilaterally.  A recent review of our claim denial trends has identified that many providers are not billing appropriately in regards to laterality. For specific guidance for reporting a diagnosis that designates a condition on the left and right versus a bilateral diagnosis, refer to the ICD-10-CM Official Guidelines for Coding and Reporting FY 2019, specifically, the General Coding Guidelines Section and the Chapter Specific Sections.  Please carefully consider the information contained in the ICD-10-CM Coding Guidelines when trying to decide between reporting a condition using left diagnosis and right diagnosis codes versus a bilateral diagnosis code.

 



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July 2019 Anthem Provider News - Indiana