Pediatric Coding Alert

You won't code 'runny nose,' 'caregiver' every time you see one

Although new entries for "runny nose" and "scratchy throat" might make you think you've hit the jackpot, you should reserve this diagnosis for specific cases. Get the lowdown on when to report these signs and symptoms, as well as whom ICD-9 2008 considers a caregiver for a "vaccination not carried out" code. Rethink Your Allergy Symptom Coding
 
ICD-9 2008 may make it easier for you to thumb to the correct code for two respiratory symptoms. You may have additional index entries for:

• runny nose (784.99, Other symptoms involving head and neck)

• scratchy throat (784.99). Reserve reporting these codes for instances in which the pediatrician makes no definitive diagnosis. Use signs and symptoms when the physician didn't know at the time of work the patient's specific condition, says Vicky V. O'Neil, CPC, CSS-P, president of The Hazlett Group in St. Louis.

Example: A patient complains of a runny nose with clear discharge for several weeks, no fever. The pediatrician refers the patient to an allergist for possible allergy testing.

But because no test results are available, the pediatrician does not diagnose allergies. In this case, you should report the sign and symptom, runny nose (784.99), available for claims dated Oct. 1 and later.

Caution: Never let your fingers do the walking in the Alphabetic Index alone. "Verify the code number in the Tabular List, Volume 1," O'Neil says. You could miss valuable coding instructions if you skip this step.
 
Count These People as Caregivers If you're not sure who qualifies as a "caregiver" under V64.05 (Vaccination not carried out because of caregiver refusal), expect ICD-9 2008 to weigh in on the legal issue. Look to an inclusion note following the code to indicate the term includes "guardian refusal" and "parent refusal."