Final answer:
For a medical practice to achieve reimbursement, insurance claim forms must be completely filled, and diagnostic codes must correctly match the procedure codes. ICD codes are found in patient medical records and on the insurance claim forms submitted for reimbursement.
Step-by-step explanation:
To achieve reimbursement for medical practices, certain criteria must be met when submitting an insurance claim. All the fields on the insurance claim form must be complete to avoid delays or denials of payment.
Additionally, the diagnostic code must accurately reflect the condition being treated and match the procedure code that details the specific services provided. These codes should align to indicate that the services are medically necessary based on the diagnosis.
In the context of a medical office, two locations where one would likely find ICD codes include patient medical records, where diagnoses are recorded, and on insurance claim forms that are submitted for reimbursement. When medical coders assign the ICD codes for procedures performed, these are included on the claim forms sent to insurance companies. Furthermore, these codes are used in the health-care management systems to ensure the appropriateness of treatments and laboratory work.