Don’t Get Burned Coding These Common Summer Health Concerns
With high temps just kicking off, prepare for these fun-in-the-sun encounters. Summer is officially here — and that means pediatric offices will see an increase in myriad warm weather-related health cases. The coding for the following conditions may seem simple enough, but there are a few details to review. Let’s take a look at some common encounters your pediatric office is likely to see in the next few months, and how to code the diagnosis for each of these cases. Code for Heat Rash Correctly Heat rash, also referred to as prickly heat, appears as small red bumps or tiny blisters filled with fluid and is intensely itchy. This condition is typically observed during times of intense heat and humidity. The most commonly affected areas are the upper chest and back, the neck fold, around the hairline, or under the diaper, but can be found anywhere on the body. Limiting exposure to extended periods of heat or high humidity environments can help lower the risk of developing a heat rash. The diagnosis code for heat rash is L74.0 (Miliaria rubra). Pause for Poison Ivy Poison ivy manifests as a red, scratchy rash that can form blisters and expand. It can be spread if the plant's oil is moved to other parts of the body or to other individuals. Early identification and treatment are crucial. You can report poison ivy, or poison oak or sumac, which may also manifest as rashes, with L23.7 (Allergic contact dermatitis due to plants, except food). Successful Swimmer’s Ear Dx Swimmer’s ear is also known as otitis externa. Other terms your provider might use for otitis externa in their notes include “beach ear” or “tank ear.” ICD-10-CM codes to choose from for this condition include: Because this diagnosis specifies laterality, your provider needs to document which ear they treated. If not, you need to choose code H60.339 (Other infective otitis externa, unspecified ear). . Diagnosis: The pediatrician typically identifies acute swimmer's ear through a physical examination. However, they may also send a sample of the ear discharge to a lab for testing. This process helps identify the specific organism causing the infection, and determines the most effective antibiotic for treatment.Top of Form Treatment: Your provider will sometimes treat conditions such as otitis externa and diffuse acute otitis externa by ear wick placement — a surgical procedure. This procedure involves a physician applying liquid medication to a sterile, compressed sponge, which gently and evenly expands to fill the ear canal, dispersing the medication and applying gentle pressure to the tissue. They then insert the sponge gently, usually under direct visualization, taking care not to push it in too deep. Look to the following codes when treating these cases: Know the Degree of Sunburns First-degree sunburns affect the surface of the skin and require little, if any, treatment. However, the provider may decide to provide some kind of service for this condition. For a first-degree sunburn, there will be no treatment other than local treatment; for example, applying aloe or an antibiotic ointment to aid in healing. There is usually no dressing required for minor burns such as this. Second-degree sunburns are more severe, however, requiring more extensive treatment. Because they have gone below the surface of the skin and into the dermis, they are regarded as being partial-thickness burns. This means that they have probably blistered, so the burn area will normally require debridement and dressing. Third-degree sunburns are characterized by intense red to purple skin discoloration and skin that has formed blisters. They may also be accompanied by symptoms such as chills, a slight fever, feelings of nausea, headaches, or signs of dehydration. Diagnosis coding: Depending on the degree of the case of sunburn you determine, you will report one of these ICD-10-CM codes for the sunburn diagnosis: Take This Heat Exhaustion Dx Help When a patient presents to your office with symptoms of lightheadedness, nausea, fatigue, and an elevated body temperature, these are all signs of heat stroke or heat exhaustion. You will not code the signs and symptoms separately because according to ICD-10-CM Official Guidelines, Section I.B.5, “Signs and symptoms that are associated routinely with a disease process should not be assigned as additional codes, unless otherwise instructed by the classification.” Because these are the signs related to heat stroke or heat exhaustion, you will simply look to codes T67.5- (Heat exhaustion, unspecified) and you will need to code to the appropriate 7th character: Lindsey Bush, BA, MA, CPC, Production Editor, AAPC
