Internal Medicine Coding Alert

Reader Questions:

Extend Fever Dx to 5th Digit, or Land in Hot Water

Question: One of our Medicare patients came to us yesterday with a high fever, along with nausea and vomiting. I have heard that there are some new fever diagnosis codes coming when ICD-9 2009 begins. Is there any truth to that?

Michigan Subscriber

Answer: ICD-9 2009 does bring some changes to the fever code set, deleting 780.6 (Fever) and replacing it with four new, more specific fever codes.

If you file the claim for services your internist provides in September, report 780.6 and 787.01 (Nausea with vomiting) to represent the patient's presenting symptoms. This diagnosis coding will be correct for all encounters that occur through Sept. 30.

However, if you are filing the claim for services the physician provides on or after Oct. 1, report 787.01 and choose one of the following for the fever diagnosis:

• 780.60 -- Fever, unspecified

• 780.61 -- Fever presenting with conditions classified elsewhere

• 780.62 -- Postprocedural fever

• 780.63 -- Postvaccination fever.

-- Answers to You Be the Coder and Reader Questions were reviewed by Bruce Rappoport, MD, CPC, CHCC, a board-certified internist and medical director of Broward Health's Best Choice Plus and Total Claims Administration in Fort Lauderdale, Fla.

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