Tough Topics in the FQHC: Obstetric Diagnosis Reporting

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Diagnosis reporting for obstetric care can be one of the toughest challenges facing any clinic. While payment for services has traditionally been based on service coding, diagnosis reporting is on the rise. Appropriate diagnosis reporting can justify medical necessity for a variety of services, including when to report additional E/M codes for those services that fall outside of the scope of global obstetric care. To add to the complexity, diagnosis descriptions in ICD-10-CM often do not parallel clinician thoughts regarding similar phrasing. We’ll explore the impact of ICD-10-CM on all of the above as well as UDS measures and risk adjustment programs. We’ll also discuss how to translate clinician-speak to ICD-10-CM code speak and helpful approaches to clinician education.