Otolaryngology Coding Alert

Question: What diagnosis should we use for tonsillith (stones of the tonsils that can flick off the tongue)?

New York Subscriber


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  Answer: Although tonsillith is considered a precursor to tonsillitis, it is more accurate to use 474.8 (other chronic disease of tonsils and adenoids) than 474.00 (chronic tonsillitis).

Although some physicians shy away from nonspecific codes such as 474.8 (identified by an amber, diamond-shaped symbol in the ICD-9 book) because carriers are more likely to question these codes, there are situations where the nonspecific code is the best choice.

Sometimes these codes are all you have, because some conditions have no specific ICD-9 codes. The ICD-9 book does not (and probably could not) list a separate ICD-9 code for every conceivable human condition. There are times when ICD-9 codes ending in .8 or .9 best describe the condition, and when that happens, its better to use these codes than a wrong code.

An even better illustration of when a nonspecific code must be used involves cicatrix (scarring) of the trachea. The only ICD-9 code available for this condition is 478.9 (other and unspecified diseases of upper respiratory tract; abscess, cicatrix; of trachea), because a more specific ICD-9 has never been assigned.