Accurate diagnostic coding can improve payment timelines, help ensure accurate recordkeeping, and ultimately contribute to better overall patient care.

Specificity

Specificity in both documentation and diagnosis coding is critical to ensuring accurate reporting.

• Code to the highest level of specificity based on documentation.
• Use unspecified codes only when documentation does not support specific codes.
• Never report a condition that no longer exists.

Phase of condition

In addition to the level of detail, the phase of the condition is also important.

• Acute code: Use when a current condition exists on an acute basis for which the patient is receiving active treatment
• History code: Use when there is a history of the condition, but the patient has no further symptoms and requires no further care.
• Sequela code: Use when a condition has late effects, such as residual effects of a stroke or an injury.

To learn more about acute, history, and sequela codes, refer to Best Practices to Improve Documentation Accuracy.

Additional resources

Visit our ICD-10 resource center at MedicareProviders.Cigna.com > Provider Education. Here, you’ll find an ICD-10 Code Clarification List and Best Practices and Guidelines for Risk Adjustment and ICD-10 Coding:

• ICD-10 Provider Partnership Guide
• ICD-10 Quick Desk Reference Guide
• ICD-10 On-the-Go Pocket Guide
• Documenting and Redocumenting Chronic Conditions Flyer
• Potential Conditions Flyer

On-site education

To request on-site education for your practice support team, send an email to ProviderEducation@Cignahealthcare.com.

Questions?

Contact your Provider Performance Enablement representative.