What Is A Diagnosis Pointer

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 first pointer designates the primary diagnosis for the service line. 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.

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The diagnosis pointers connect the medical diagnosis made by the provider to each cpt code that is billed.

What is a diagnosis pointer. Unsubscribe from learn medicare billing for pt ot slp. Enter procedure information in the normal manner save for item 29a. A diagnostic pointer is a block capital letter a b c or d referencing the code entered on the corresponding line in item 34a. You can list up to four diagnosis pointers per service line.

What is a diagnosis pointer cms medicare billing physical therapy learn medicare billing for pt ot slp. 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. 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. 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.

Why are diagnosis pointers used. Diagnosis pointers are used to link the diagnosis code to a cpt the current procedural terminology performed. Diagnosis code pointers are used to indicate the appropriate order of importance in relation to the service being performed. 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.

Remaining diagnosis pointers indicate declining level of importance to service line. 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. Where did diagnosis pointers come from. Enter each pointer as appropriate in item 29 for each service where a diagnosis is required.

Pointers originated with paper claims.