Medical billing is hard enough with it having to be cryptic besides. Unfortunately, there is nothing more cryptic than DX, or diagnosis code tables when it comes to DME billing. In this installment, we're going to try to make some sense of DX tables and give you some basic information that you'll need to know in order to understand how to use them when submitting a bill using your DME software.
DX tables, or diagnosis code tables, are tables of data that pertains to a diagnosis of a patient's illness. This has nothing to do with the type of equipment they are getting or their insurance or anything else. It is simply a designation of what it is that the patient is suffering from. Now, this might sound pretty basic, but the problem is that there are more diagnosis codes than New York City has people. As a matter of fact, diagnosis code tables are so massive that updating them regularly is a big business in the medical billing industry. But that's a topic for another article.
The table is actually very small. It contains just two items. The first is the actual code itself. The second item is the description that goes with the code. These can be listed in the table in one of two ways depending on how your software works. The codes can either be listed in alphanumeric order by the actual code number or they can be listed in alphabetical order by the name of the disease or condition. Some software allows you to index your table either way. Why? Because some medical billing personnel prefer to look up the DX codes by the name of the illness. The reasons are obvious. Who wants to memorize all those codes, though some people actually do just that. Boggles the mind.
In your DME software, there will be a box on your line item where you can enter what is called a pointer to your DX code. The DX code itself is stored in the patient's history file. This file contains all the information about the patient including what is clinically wrong with the patient. You can have as many as four diagnosis codes for a patient in most software and in some cases can have as many as eight. If you think it's not possible for a patient to have that many problems, it is. A typical cancer patient in advanced stages can have a cancer DX code, one for poor respiration, if the cancer is of the lungs and a number of other ailments.
When the actual bill is sent, the software cross-references the DX pointer to the actual DX code in the patient's file and transmits the code to the carrier, NOT the pointer. It is important that you understand this. Many billers who do not understand this try to take out the pointer from the line item and manually enter in the code. This will result in nothing being sent to the carrier.
DX tables usually work by themselves as part of the software functions. So if you simply just leave well enough alone, you should have no problems getting your claims through to the insurance carrier and paid.
