Primary Care Coding Alert

Question: Which code should we use for sick-building syndrome?

Nevada Subscriber  
Answer: Sick-building syndrome is a collection of complaints with variable findings, not an actual disease. Patients who work in buildings with poor ventilation that may spread fungus, bacteria and other harmful organisms are said to have sick-building syndrome. There is no specific code for this, so code for the patients symptoms. Patients with this syndrome often present with shortness of breath (786.05), fatigue (780.79), cough (786.2) and/or allergic reactions (995.3). 
 
Another option is to use 495.7 (Ventilation pneumonitis, allergic alveolitis due to fungal, thermophilic actinomycete, and other organisms growing in ventilation [air conditioning] systems). However, this code can only be used if there is concrete proof that the building ventilation system is spreading infectious organisms. Often, patients who present with sick-building syndrome assume it is due to the ventilation system because the other employees have similar health problems. If a patient with these symptoms verifies that his or her building was found to have a harmful ventilation system, use 495.7. But if the patient merely says that other employees have similar symptoms and they believe it is due to the building, do not use this code.

  Reader Questions and You Be the Coder were answered by Kent Moore, manager of Health Care Financing and Delivery Systems for the American Academy of Family Physicians; and Daniel S. Fick, MD, director of risk management and compliance for the College of Medicine faculty practice at the University of Iowa.