Common use of Diagnosis Codes Clause in Contracts

Diagnosis Codes. The values in all Diagnosis fields listed in Data Elements section should be submitted when available. Submit on Dental claims when available. Requirements for validity and completeness are detailed in the ICD clinical guide published by the American Medical Association. Current validating process at MH DW requires: • at least one diagnosis code (in Primary Diagnosis field #19) for all applicable encounter types as specified in section 8.0. • diagnosis codes contain the required number of digits outlined in the ICD code books. • code to the seventh digit when applicable (blank filled when less than seven digits are applicable). DO NOT include decimal points in the code. For example, S72.111A must be entered as S72111A. • Diagnosis Code must be consistent with ICD Version Qualifier.