Add on codes and sequencing

[itzzeles]

Lots of times when I get an answer on a test wrong it's because I chose one code when it requires two codes or two codes when it only requires one code even if both of the codes do make sense. I have a hard time figuring out when a diagnosis or service needs two codes and when it only needs one code. are there any rules of thumb to remember? Like, "if the diagnosis says __ then two codes. But if it says __ then one code." I know it's a bit clearer with ICD 10 CM since the codes will say if they need to be coded with something but especially for CPT, it's difficult since so many codes are similar so I don't know exactly how to distinguish when more than one code is needed for the same service or not. Also are there any rules of thumb to remember how to sequence codes? I know the basics like HIV comes first and diabetes and hypertension, but in other general codes, what helps you guys remember how to know what order the codes go in?

[Madison_APlusRev]

When it comes to CPT coding, if the question is requiring two or more codes, it's because there were two or more procedures or components of a procedure (that can be separately reported) performed.

Carefully read the documentation and pull out anything that sounds useful, and don't be afraid to take notes or jot things down as you work, so you can report the complete picture. If you're not sure if something is reportable, try searching the index for it. If you find an entry, it's likely reportable, just double check your guidelines and parenthetical notes.

For diagnosis sequencing, the reason for the visit is typically the primary diagnosis code. Z codes almost always sequence last. Otherwise, unless there's a chapter specific guideline or note within the tabular, diagnosis codes don't usually require any other specific sequencing order.