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ICD-10-CM Coding:

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

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