MO HealthNet Division (MHD) receives inquires regarding MHD policy for claim denials concerning multiple surgical procedures on the same patient on the same date of service. Please refer to Section 13.33.F of the Physician Provider Manual for additional information on billing for multiple surgical procedures.
As stated in the Introduction to the International Classification of Diseases Ninth Edition (ICD-9) Official Guidelines for Coding and Reporting, a joint effort between the healthcare provider and the coder is essential to achieve complete and accurate documentation, code assignment, and reporting of diagnoses.
The Temporary Assistance for Pregnant Women (TEMP) program, ME codes 58 and 59, is fee-for-service only and is limited to ambulatory prenatal care.
A pregnancy or prenatal diagnosis code is required on the claim form in one of the diagnosis fields. If the TEMP participant is provided illness care, the illness diagnosis code must appear as the primary diagnosis code. However, a pregnancy or prenatal diagnosis code must also appear on the claim form.
