What happens if the admitting diagnosis code at the time of admission certification has a different extension than the code on the claim submitted to HFS?
Any admitting diagnosis code with the same root diagnosis codes on Attachments A and B that requires a 4th or 5th digit extension are subject to review. Therefore, as long as the hospitalization was reviewed, even if the 4th or 5th digit extension reported on the claim differs from the one provided during admission review request, the claim will not be rejected for failure to obtain certification.
