International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes must be recognized as part of the standard code sets by all payers as mandated by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Therefore, adhere to the specific reporting guidelines for physician services (located in sections I and IV of the ICD-9-CM manual).

Reporting a diagnosis on a patient who is seen in follow-up appears to puzzle many physicians, mainly because of payers who require reporting follow-up care in a manner that is not consistent with ICD-9-CM guidelines. Practices should be aware of payer guidelines but should try to adhere to the coding conventions under HIPAA.

The guidelines for reporting follow-up and aftercare services that are provided by physicians are detailed in Section I, Conventions, General Coding Guidelines, and Chapter-Specific Guidelines, of the ICD-9-CM manual. It is recommended that they be carefully reviewed.

Follow-up care codes are...

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