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ED Coding and Reimbursement Alert

Reader Question:

NOS Codes Salve Unknown Skin Rash Dx Issues

Published on Thu Jan 20, 2011

Question: A patient recently reported to the ED with a rash on his chest and abdominal area. After a level-three service the nonphysician practitioner (NPP) decided that the rash was from an "allergic reaction, cause unknown." Notes indicate that the NPP sent the patient to a dermatologist for further treatment. How should I choose a diagnosis code for this patient?Answer: There are several possibilities for coding the unknown skin rash. More information from the NPP will help to identify the ICD-9 code to append to 99283 (Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: an expanded problem focused history; an expanded problem focused examination; and medical decision making of moderate complexity...).When deciding the most appropriate code, consider these options:You may consider selections from category 692.x (Contact dermatitis and other eczema). This category includes "Dermatitis: Not Otherwise Specified (NOS), contact, occupational, venenata"; [...]
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