expectations around specificity of codes

Do any organizations have metrics around the number of diagnoses, both primary and secondary, that are expected to be coded to the most specific possible ICD-10 code?  Thanks for the help! 


  • While HIM would like every diagnosis coded to the highest specificity possible, we understand there is a limit to Provider tolerance to number of queries. Our program prioritizes specificity for PDX, then secondary diagnosis that add CC's,MCC's or improve SOI/ROM. We also have one "focus diagnosis" per month that we query as a teaching tool even if it does not impact those metrics on that account. I hope that is helpful.
  • We try to code to the highest possible degree of specificity but we are also very aware of the realities of over querying our physicians. 

    We try to ensure maximum specifity for PDx and procedures but are realistic about querying if it is not going to add additional value.

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