CMS Pub. 100-04, ch. 23, § 10.1

The Official ICD-9-CM Coding Guidelines can be found at

http://www.cdc.gov/nchs/icd/icd9cm_addenda_guidelines.htm

The Official ICD-10-CM and ICD-10-PCS Coding Guidelines can be found with the annual ICD-10-CM

and ICD-10-PCS updates at http://www.cms.gov/Medicare/Coding/ICD10/index.html

The CMS understands that physicians may not always provide suppliers of DMEPOS with the most specific

diagnosis code, and may provide only a narrative description. In those cases, suppliers may choose to utilize

a variety of sources to determine the most specific diagnosis code to include on the individual line items of

the claim. These sources may include, but are not limited to: coding books and resources, contact with

physicians or other health professionals, documentation contained in the patient’s medical record, or

verbally from the patient’s physician or other healthcare professional.

Beneficiaries are not required to submit diagnosis codes on beneficiary-submitted claims. Beneficiary-submitted claims are filed on Form CMS-1490S. For beneficiary-submitted claims, the A/B MAC (B) must

develop the claim to determine a current and valid diagnosis code and may enter the code on the claim.