Any experiences with having past diagnostic codes on insurance claims changed due to a misdiagnosis?

If my son had seen a counselor who initially diagnosed with one condition, but later recognized that this was a misdiagnosis, would the counselor be able to retroactively change the diagnostic codes associated with the previous insurance claims to corrected ones?

For example, let's say a provider were to change the diagnosis to something that is NOT covered by a patient's insurance. The provider could resubmit all previous claims that have the incorrect diagnostic code with the updated, correct diagnostic code. The provider would be required to pay a clawback to the insurance company for these past claims, since the updated diagnoses are not covered by the patient's policy. Then, the provider would charge the client their out-of-pocket rate for all the previous sessions.

Would this remove any and all insurance records of the misdiagnosis? Additionally, has anyone seen this happen successfully?

Thanks for your help!

submitted by /u/kylekun_
[comments]

See also  Ninth Circuit Reverses Behavioral Health Coverage Case - The National Law Review