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The page below is a sample from the LabCE course Medicare Compliance for Clinical Laboratories. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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International Classification of Disease (ICD) Coding

ICD codes are used for the classification of diseases and conditions, and for describing signs, symptoms and medical circumstances. These codes are used to indicate the medical necessity of a particular test. All employees who are directly or indirectly responsible for reporting to Medicare must be aware of these guidelines to prevent fraudulent claims:
  • ICD codes can only be supplied by the ordering physician or a representative of that physician.
  • ICD codes cannot be used from a previous laboratory order.
  • If a physician supplies a narrative description instead of an ICD code the laboratory must accurately translate that code using only certified coders.
  • It is against the law to use the wrong ICD code for the purpose of causing or increasing payment for a test.
ICD 10, the 10th revision of the International Classification of Disease coding, is the edition that is currently in use in all U.S. health care settings.