Specificity

Have you picked the code with the highest number of digits available in the category?
 

Example: In this family of codes for speech disorders, the highlighted codes are billable because they are carried out to the highest number of digits available within each specific category or subcategory.

R47 Speech disturbances, not elsewhere classified

       R47.0 Dysphasia and aphasia

                  R47.01 Aphasia

                  R47.02 Dysphasia

        R47.1 Dysarthria and anarthria

        R47.8 Other speech disturbances

                  R47.81 Slurred speech

                  R47.82 Fluency disorder in conditions classified elsewhere

        R47.9 Unspecified speech disturbances

 

Have you coded to the highest degree of certainty possible? In other words, have you picked the code that is most descriptive of the reason for the visit?
 

Example: Looking at the same family of codes for speech disorders, the highlighted code is billable, but it's not as clinically specific as the other codes in the family. Avoid codes with terms like "unspecified" or "not otherwise specified (NOS)" unless the clinical and medical information you have isn't enough to assign a more specific diagnosis.

R47 Speech disturbances, not elsewhere classified

       R47.0 Dysphasia and aphasia

                  R47.01 Aphasia

                  R47.02 Dysphasia

        R47.1 Dysarthria and anarthria

        R47.8 Other speech disturbances

                  R47.81 Slurred speech

                  R47.82 Fluency disorder in conditions classified elsewhere

        R47.9 Unspecified speech disturbances

 

A physician may include a less specific diagnosis, like R47.9, on a referral for speech-language pathology services. As the qualified health care professional, you can change this treating diagnosis once you see the patient and have gathered enough medical and clinical information to code to a higher degree of certainty and specificity.