Pediatric Coding Alert

Your coding options next October will fortunately be transitioned on a one-to-one basis.

Rotavirus is a common childhood illness which causes symptoms such as fever, diarrhea, and vomiting, and can lead to dehydration if left untreated—and one that you probably face all year-round. Fortunately, the introduction of ICD-10 next year shouldn’t cause too many headaches for you, thanks to a one-to-one code transition for this common childhood illness.

ICD-9 Coding Rules: ICD-9 provides one specified code for the common pediatric diagnosis of Rotavirus, which is 008.61 (Enteritis due to Rotavirus). "Enteritis" refers to an inflammation of the small intestine, and 008.61 describes this condition when specifically caused by the rotavirus.

ICD-10 Change: Effective Oct. 1, 2014, you’ll report the new ICD-10 code A08.0 (Rotaviral enteritis) for patients who present with confirmed rotavirus. This code represents only the type of enteritis caused by the rotavirus, and not any other types of enteritis, diarrhea, or vomiting.

Documentation: You should not report the rotavirus diagnosis code unless your practice receives confirmation from a stool sample indicating that the patient tested positive for the virus. Until then, you’ll code based solely on symptoms, such as fever, diarrhea, or vomiting.

Therefore, your documentation must include confirmation that the patient had rotavirus before reporting A08.0. If possible, retain a copy of the laboratory report confirming that the patient had rotavirus.

Coder tips: You’ll scrap the 008.61 option and turn to A08.0 in your ICD-10 manual. Except for the change in code number and the addition of a letter, you should treat these claims the same as before.