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Neurology & Pain Management Coding Alert

YOU BE THE CODER ~ Talk With MD About Feigned-Illness Diagnosis

Published on Mon Feb 05, 2007

Question: Our neurologist saw an ED patient who complained of migraine pain. After examining the patient, our physician believed the patient was trying to get a pain medication prescription. What diagnosis should I report?

New York Subscriber

Answer: Your best option is to code according to your physician's note.

If he states in his impression that he believes the patient is faking the illness, report V65.2 (Person feigning illness). If you (and your physician) feel more comfortable with a more conservative route, report a generic headache code such as 784.0 (Headache), or 346.9x (Migraine, unspecified) if your neurologist actually diagnosed a migraine. 

Document it: If your physician really believes the patient is seeking drugs, he should flag the patient's chart for future reference.
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