Radiology Coding Alert

Question: What codes should I use for the radiological supervision and interpretation for posterior fossa myelography using a cervical approach performed for a patient with meningitis due to a Histoplasma capsulatum infection?


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Answer: Report code 70010 (Myelography, posterior fossa, radiological supervision and interpretation) for the radiological supervision and interpretation, with diagnosis 115.01 (Infection by Histoplasma capsulatum; meningitis).

If your physician also performs the procedure, report 61055 (Cisternal or lateral cervical [C1-C2] puncture; with injection of medication or other substance for diagnosis or treatment [e.g., C1-C2]).

Watch for: Your ICD-9 manual index includes multiple entries for meningitis, so pay extra attention to the documentation regarding the cause or type of the meningitis.

Example: Although meningitis in histoplasmosis is caused by inhaling fungal spores, the code for "Meningitis in other fungal diseases" (ICD-9 321.1 ) is incorrect. This code specifically tells you to exclude meningitis in histoplasmosis.

Pitfall: Code 321.1 and many other meningitis codes are manifestation codes. This means you need to code the underlying disease first.

Example: Report 116.0 (Blastomycosis) as the primary code and 321.1 as a secondary diagnosis.