What Is A Diagnosis Pointer

There are two ways that you can link a diagnosis code to a cpt in drchrono one on the billing detail screen and the other through schedule calendar. Diagnosis pointers are used to link the diagnosis code to a cpt the current procedural terminology performed. The first pointer designates the primary diagnosis for the service line.

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That s because the current 1500 form allows space for up to four diagnosis pointers per line and that won t change with the transition to icd 10.

What is a diagnosis pointer. When a cpt code is billed the provider must connect or point the diagnosis to each procedure performed to treat the specific diagnosis so at least one pointer per cpt code is required and the total number of diagnosis pointers per cpt code are limited to four 4. The diagnosis pointers connect the medical diagnosis made by the provider to each cpt code that is billed. A diagnostic pointer is a block capital letter a b c or d referencing the code entered on the corresponding line in item 34a. Unsubscribe from learn medicare billing for pt ot slp.

Pointers originated with paper claims. Why are diagnosis pointers used. In the example the letter a is entered into field 24e meaning that the diagnosis code listed in blank letter a in box 21 of this claim relates to code on that line item e0486. The diagnosis pointer s entered into field 24e of each line item show what diagnosis code s entered into field 21 that the service cpt or hcpcs code relates to.

Diagnosis pointers are used to describe sometimes complex many to many relationships between submitted diagnosis and service line treatment information on health claims and encounters. Where did diagnosis pointers come from. Diagnosis code pointers are used to indicate the appropriate order of importance in relation to the service being performed. Enter procedure information in the normal manner save for item 29a.

Enter each pointer as appropriate in item 29 for each service where a diagnosis is required. Remaining diagnosis pointers indicate declining level of importance to service line. What is a diagnosis pointer cms medicare billing physical therapy learn medicare billing for pt ot slp. While you can include up to 12 diagnosis codes on a single claim form only four of those diagnosis codes can map to a specific cpt code.

You can list up to four diagnosis pointers per service line.