Remember the 7th Character in Complication Coding
Question: I work at a behavioral health facility that offers transcranial magnetic stimulation (TMS) treatment. I recently had a claim for a patient who was experiencing an adverse effect to the treatment. The practitioner is trying to use diagnosis code T88.1, which I know is incorrect, but I am struggling to find the right code. How should this be coded instead? AAPC Forum Participant Answer: You are correct in identifying T88.1 (Other complications following immunization, not elsewhere classified) as not pertaining to this patient’s situation. Looking at the scenario you provided — and presuming this is the patient’s first encounter for the adverse effect — the payer is most likely looking for more precision. Diagnosis code T81.89XA (Other complications of procedures, not elsewhere classified, initial encounter) would be more suitable for this scenario. I would also recommend including the patient’s original diagnosis (the reason for the TMS treatment) on the claim as well. Lindsey Bush, BA, MA, CPC, Production Editor, AAPC
