Latest / Reimbursement Readiness
Ep.06 Matching Diagnosis Codes to Procedures
In this episode, Donna Cartwright explains why it’s critical to match ICD-10-CM diagnosis codes with the appropriate procedure codes outlined in Medicare’s Local Coverage Determinations (LCDs) and Local Coding and Billing Articles (LCAs). She breaks down six key reasons these code lists matter—from ensuring medical necessity and preventing improper payments to minimizing denials, reducing audit risk, and maintaining Medicare program integrity. Listeners will also learn about the risks of incorrect or unspecified coding, including overpayment recovery, sanctions, and reputational harm. This…
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