CodingQuestion 16 of 100
The primary or first-listed diagnosis on an outpatient claim should represent:
a.The condition that is easiest to code
b.Any chronic condition the patient has ever had
c.The diagnosis with the highest reimbursement
d.The main condition, chiefly responsible for the services provided during the encounter
Explanation
For outpatient encounters, the first-listed diagnosis is the reason chiefly responsible for the services rendered that day. Coexisting conditions that affect treatment may be reported as additional diagnoses. Correct sequencing supports both medical necessity and accurate reimbursement.
Practice all 100 questions free — no signup required.
Related questions on this topic
- Three key components historically used to determine the level of an evaluation and management (E/M) service are:
- When selecting an office E/M visit level by time under current guidelines, the coder should count:
- In coding, 'medical necessity' generally means that a service is:
- When a definitive diagnosis has not been established at the end of an outpatient encounter, ICD-10-CM guidelines direct the coder to report:
- The instructional note 'use additional code' in ICD-10-CM tells the coder to:
- In CPT, an add-on code is one that:
Last reviewed: · editorial process
PrepPass Editorial Team · Verified against NHA Certified Billing & Coding Specialist (CBCS) Exam · How we review