How does ICD-9 coding work when it comes to reimbursing for Medicaid?

I am interested with ICD-9 coding for Medicaid, but I have little understanding of how it all works. I was hoping that someone could give me an ';Idiot's Guide'; to these issues:





1. How does ICD-9 coding work;





2. How they work in conjuction with Medicaid Reimbursement; and





3. If the coding is for a drug that requires prior authorization, does a doctor have to supplement the code of WHY the drug is necessary (more specifically, does the doctor have to include what the drug is diagnosed for)?





Thanks! Any links to direct authority would be greatly appreciated.How does ICD-9 coding work when it comes to reimbursing for Medicaid?
most federal insurance programs like medicaid and also medicare pay claims on a fee for service basis. this means that based on the ICD-9 code the provider (doctor, hosp, vendor) gets paid a certain fee established for care of that diagnosis. that is sometimes why some providers don't accept medicaid or medicare because they lose the ability to bill for each particular service in some cases. you can learn alot about the coding and payment of services for medicaid on the cms(centers for medicare and medicaid services) website: www.cms.hhs.govHow does ICD-9 coding work when it comes to reimbursing for Medicaid?
ICD9 coding is for listing of the illness the patient has. It is imperative the code is correct in order to get payment or the insurance company will deny it or kick it back to the biller. It is not limited to Medicaid either. ICD9 coding is used in ALL medical aspects in order to treat the patient properly as well as create the patient's history with the illness and any other problems that may arise from the original illness. See if you can get an old edition of the ICD9 manual from a doctor's office when the new edition comes out. That will help you understand it better. Hope this helps!!