The CPT manual does not tell you which diagnosis goes with which procedure but maybe I can clarify a bit.
You may need to look up code descriptions in your CPT if you do not know what the procedures are or what diagnosis is appropriate to link.
I have a CMDT which can be helpful.
24E Required Diagnosis Pointer - Enter the diagnosis code number from box 21 that applies to the procedure code indicated in 24D.
Item 24E - This is a required field.
Enter the diagnosis code reference number or letter (as appropriate, per form version) as shown in item 21 to relate the date of service and the procedures performed to the primary diagnosis.
Enter only one reference number/letter per line item. When multiple services are performed, enter the primary reference number/letter for each service.
When using form version 02/12, the reference to supply in 24E will be a letter from A-L.
If a situation arises where two or more diagnoses are required for a procedure code (e.g.,
pap smears), the provider shall reference only one of the diagnoses in item 21.
24a From Dates of service Required Enter “From” and “To” dates of service in MMDDYY or MMDDCCYY format. Line fields can include no more than two dates of service for the same procedure code. Grouping is allowed only for services on consecutive days. The number of days must correspond to the number of units in 24g.
The diagnosis “pointers” connect the medical diagnosis made by the provider to each CPT® code that is billed. When a CPT code is billed, the provider must connect or “point” the diagnosis to each procedure performed to treat the specific diagnosis, so at least one pointer per CPT code is required and the total number of diagnosis pointers per CPT code are limited to four (4). This means if a provider has more than 4 diagnosis codes for one CPT billed (i.e., procedure or treatment performed), the provider must select only four (4) diagnoses to relate to each such CPT.
In general, this means that the provider should identify the four most important or serious conditions or diagnoses that a procedure is intended to treat, which should be listed in order of severity and specifically related to the procedure code they are pointed to.
Total diagnoses and diagnosis pointers are recorded differently on the claim form. Specifically, diagnosis codes are found in box 21 A-L on the claim form and should be entered using ICD-10-CM codes. The total number of diagnoses that can be listed on a single claim are twelve (12). The diagnosis pointers are located in box 24E on the paper claim form for each CPT code billed. The line identifiers from Box 21 (A-L) should be related to the lines of service in 24E by the letter of the line.
The post Diagnoses on a CMS-1500 Claim Form vs. Diagnosis “Pointers” appeared first on ModMed.
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Diagnosis pointers are represented as letters A-L. The diagnosis pointer(s) entered into field 24E of each line item show what diagnosis code(s) entered into field 21 that the service (CPT or HCPCS code) relates to.
Diagnosis pointers and where they are located on a medical claim form
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