A diagnosis is considered equivocal when there is some uncertainty as to whether it supports the disease level that forms the basis of the claim's disease level. Examples of diagnoses that would be considered equivocal could include: 1. the pathologist indicates that the findings are "suspicious for" or "possibly" the claimed disease 2. The pathologist states that further testing is required to confirm the diagnosis 3. the pathologist notes a differential diagnosis that must be ruled out 4. the diagnosis is noted to be "provisional" or "preliminary"5. the specimen is taken from a site other than the primary site and the diagnosis does not specify what the primary site of the malignancy is.
What is an equivocal diagnosis? Print
Modified on: Thu, May 21, 2020 at 7:03 AM
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