O-13-103 Verify Diagnoses in Decision Health

👤 Responsible Person

Intake

🎯 Purpose

Outlines the steps to verify a diagnosis using Decision Health Home Health Coding Center.

🔄 Process

1. Access Decision Health Coding Center at: https://codingcenter.decisionhealth.com

2. Enter username/password

   

3. If you do not have the diagnosis code, use the Alpha Index and enter diagnosis in field

   

4. If you have the diagnosis code, select Tabular codes and enter code in field

   

5. Once the code has been identified, review the icons to determine if valid primary dx under PDGM and associated clinical grouping:

   1. $P icon confirms diagnosis is eligible as primary under PDGM

      

   2. PDGM Clinical Grouping identified

      

6. Diagnosis codes with !Q icon indicate questionable diagnosis and require additional clarification from the provider or increased specificity (such as laterality, stage, etc). These codes cannot be used as primary.

   

📅 Effective: 11/27/2024  |  🔍 Reviewed: —  |  🛠️ Revised: —  |  ✅ Approved by: JS