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On a regular basis CMO will distribute ICD-9 Coding Guidelines to assist our network providers in the accurate documentation of chronic disease and other illness. As you are aware, both Medicare and Medicaid have moved to a Risk Adjusted model of funding Managed Care Plans. This Risk Adjusted model relies on the accurate submission of ICD-9 diagnosis codes to determine the financial resources available to the health plans for the care of their members. The model directly impacts the resources available to Montefiore to provide services to our IPA contracted health plan membership. Please review the guidelines provided below for providing accurate ICD-9 diagnosis coding for the indicated conditions. If you have any questions regarding the attached documentation, please contact Bill Scesney, CMO Provider Relations, at 914-377-4701. Please look for additional information on diagnosis coding in the upcoming weeks. |
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