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  1. O

    Need help with ICD-9 code

    What code would you use for "abnormal atrial conduction"? EDIT: "Aberrant atrial conduction" used in same note to describe condition.
  2. O

    CPMAs that took the NAMAS training course

    I live in South Florida and NAMAS is holding their CPMA training course down here in October. I was hoping that some of you that have taken the course can give me some information on how valuable it was to your success in achieving your CPMA credential. It is only a 2 day course, which kind of...
  3. O

    How would you code this DX??

    DX: Diabetes mellitus type 2 with exudative macular degeneration How would you code this? Any assistance appreciated. Thanks in advance!
  4. O

    Need help with ICD-9 code

    I need assistance finding a code. DX reads as follows: "Colon reticulosis with disruptive mucosa" Any help is greatly appreciated. Thanks in advance!
  5. O

    what to code: diagnosis vs diagnosis

    Yes, it should be indicated in the final impression/assessment. If you see that it was written throughout the body of the note, but the doc forgot to add it to his final impression, I would take the documentation back to the doctor for clarification, if that is even a possibility. That is how I...
  6. O

    what to code: diagnosis vs diagnosis

    When documentation indicates uncertainty in the diagnosis, it cannot be coded. In the case of the doctor documenting DX versus DX, neither can be coded. Instead, code signs and symptoms, to the highest degree of certainty for the encounter, until a definitive diagnosis is given. (This rule is...
  7. O

    billing EM level based on addendum

    Read this for some info into what you're looking for: http://www.hcpro.com/HIM-251599-5707/QA-Policies-for-late-entry-documentation.html
  8. O

    Help with Dx code

    I agree with dadhich.girish.
  9. O

    Copd

    I agree with terribrown.
  10. O

    Job interview

    It really depends on how you word things. YOU may be okay with someone asking you flat out during a first interview, "What's the pay? Do you guys pay for my CEU's and keeping my credential/membership current?", but I know many others that are VERY turned off by these subjects being brought up...
  11. O

    Soft tissue mass in the esophageal gastric junction

    Anyone have any suggestions on this one?
  12. O

    deer tick removal

    Well, I'm going to go with yes, it's incorrect, for the tick removal and no, it's not incorrect, for the tick bite. AAFP is a fairly reputable source of information, that I know. However, I have never heard of "codingnews.inhealthcare.com" so I cannot speak on that. Anyway, the reason that I say...
  13. O

    Job interview

    I, 100%, agree with FTessa. This is NOT the type of question to ask during the first interview.
  14. O

    Soft tissue mass in the esophageal gastric junction

    Hope everyone had a nice Memorial Day weekend! Unfortunately, it's time to get back to work. I'm hoping someone can help me with this DX, "soft tissue mass in the esophageal gastric junction". I'm not sure what to assign here. It's pending evaluation so, until then, this is the most definitive...
  15. O

    Coding Acute DVT vs Chronic DVT

    It has nothing to do with when the patient is started on medication. Assumption is one of the biggest no-no's when it comes to coding. That is exactly what you would be doing if you were to assign the code for chronic DVT solely because the patient was started on an anticoagulant. To code...
  16. O

    Help with Hypertension Codes

    Per ICD-9-CM coding guidelines, "Assign codes from category 403, Hypertensive chronic kidney disease, when conditions classified to categories 585 are present. Unlike hypertension with heart disease, ICD-9-CM presumes a cause-and-effect relationship and classifies chronic kidney disease (CKD)...
  17. O

    Pseudohypertension

    I don't know, this one is iffy. The only code that you could use is 796.2 BUT I'm not sure if it should be coded at all. From the information I've gathered, pseudohypertension is basically abnormally high blood pressure reading that ends up not actually being an abnormally high blood pressure...
  18. O

    Uncontrolled type II diabetes mellitus.

    250.4X is the code for DM II with RENAL manifestations. Therefore, if the doctor documents the patient as having DM II with mild renal insufficiency, it would code to 250.4X and the code for the renal manifestion, whatever the renal manifestation may be. Hope this helps!
  19. O

    Quiescent Prostate CA

    Quiescent basically means inactive, and in this context, aka in remission. Therefore, the dx is "history of prostate cancer, in remission" and should be coded as V10.46. As for the 5 year rule, it should prove fairly difficult to find documentation of this rule, as it does not exist. To find...
  20. O

    help with icd-9 code because i'm having one of those days

    Should periorbital ecchymosis, due to a fall, be coded as 921.1 or 921.2? Doctor explains that the patient has ecchymosis, periorbital, right side with extension toward the right frontal region. I know that code 921.2 states Contusion of orbital tissues but I was thinking that maybe 921.1 was...
  21. O

    Asthma check

    You SHOULD be using the asthma code, as the patient does have asthma, but the documentation must match. All that needs to be done is a correction addendum clarifying the diagnosis. I mean, I get it, the doctor means that the patient has a long history of asthma. Let's be honest though, we know...
  22. O

    Asthma check

    Helen, Do you have the opportunity to speak with the doctor about the use of the term "history"? If the doctor documents hx of, but really means that the patient still has whatever the "hx of" may be, you should take the documentation back to the doctor and educate them on the use of the word...
  23. O

    ICD-9 for Android??

    Honestly, I realize that lugging around the books might become quite tiresome but I would still have to agree with m.j. kummer. I use my books 100% of the time and only use the internet as a source of reference when I get stuck on something. Even if you did find a mobile app, I wouldn't suggest...
  24. O

    Icd9

    No other info? I would say that means that nothing is addressed making the DX irrelevant to patient management. Omit code or take documentation back to the provider for elaboration. Please remember that you should not be coding diagnoses that are not managed/treated/addressed during a patient...
  25. O

    diag help please

    I agree.
  26. O

    Pelvic pain - Can somone help me

    I'm going to stick to my answer and respectfully disagree with you, eadun. You can say the same thing about you assuming that 625.9 and 789.09 are the correct codes. There is more than one code for pelvic pain, one of them being 719.45. 789.09 is the code for abdominal pain in the pelvic area...
  27. O

    Pelvic pain - Can somone help me

    I'm actually going to go with srinivas and lean towards the 719.45 code for pain in joint, pelvic region and thigh due to fall. I feel like 789.09, abdominal pain, other specified site , and 625.9, unspecified symptom associated with female genital organs, would be better suited for pelvic pain...
  28. O

    History of UTI

    I disagee with gailmc. If the doctor documents hx of, but really means that the patient still has whatever the "hx of" may be, you should take the documentation back to the doctor and educate them on the use of the word history. Under ICD-9 Guidelines, the term "history of" means that the...
  29. O

    CPC Exam is tomorrow help needed

    I agree with the others telling you to skip troublesome questions and come back to them later. Just make sure that you mark the questions that you are skipping, on your answer grid, so that you do not accidentally plug in an answer that belongs to a different question. That could really screw...
  30. O

    diagnosis code

    722.9X isn't even the correct code for bulging disc unspecified. The unspecified code for bulging disc is 722.2. 722.9X is just the wrong assignment altogether.
  31. O

    cholelithiasis and history of jaundice

    Why are you coding off of a charge slip? You need to be coding from the doctor documentation.
  32. O

    diagnosis code

    Bulging disc, aka herniated disc/ slipped disc/ disc displacement, in the cervical spine codes to 722.0 unless it is stated as "due to trauma" of some sort or unless it is stated as "with myelopathy". The way that you would get there, though, is to look in the Index under Displacement >...
  33. O

    need dx help

    I have a patient that has mild memory loss due to status post basal ganglia intracranial hemorrhage. I'm trying to make certain that I'm assigning the right codes, as this patient is a capped member, reimbursement being HCC based and one of my codes are MRA. Doctor states: "Status post basal...
  34. O

    deer tick removal

    I just googled "icd 9 code for tick" and the first link that was provided included the following information. http://www.aafp.org/fpm/2006/0300/p33.html ICD-9 code for tick removal QWhat is the proper ICD-9 code for removing a tick? AThere is no specific ICD-9 code for tick infestation on...
  35. O

    deer tick removal

    Isn't there a code in the parasite section of the icd 9 book for ticks? I thought deer ticks were the leading cause of Lyme disease in the US so wouldn't there be a code? It seems to me that ticks are parasites and having one latch on is not the same as your run of the mill ant bite. Just a...
  36. O

    Icd9 help!

    I would assign 429.3 for the DX of atrial enlargement.
  37. O

    still learning

    I'm guessing that there was on abnormal finding on the bronchoscopy..? Is that documented? If it is, you can use V81.4, special screening for other and unspecified respiratory conditions, along with the code for abnormal findings on examination of the lung field. I believe the code is 793.1. If...
  38. O

    Help with icd-9 code, please?

    I am finding contradicting answers for a DX code that I needed. I was having trouble finding the appropriate code so I'm going to go ahead and hope that someone here can help me. DX: Cervical myofascial pain I'm finding, both, 723.1 or 729.1 as possible answers. So what do you think? 723.1...
  39. O

    Coding for Drug or Alcohol Abuse

    Thinking about it in terms of the care given during a patient's visit, the use of alcohol is almost always, if not always, going to have a major bearing on the medical decisions made. Alcohol (and drug) abuse and dependence takes a major toll on the users body and can really effect any aspect of...
  40. O

    Coding for Drug or Alcohol Abuse

    How did they come up with that information, exactly? You do not have to be a mental health provider to document a patient with alcohol dependence or abuse. The patient does not have to be in a program either. Alcoholism is considered a chronic condition. Per the official coding guidelines...
  41. O

    Not sure what Dx code to use for this report?

    I agree with using 785.6 since it specifically states "Enlarged right axillary lymph node". 611.72 and 611.8 are not supported by, either, the Findings or Impression.
  42. O

    ICD9 history

    A complication code is NOT acceptable to use for documentation written as "history of indwelling catheter", especially if the doctor does not give you a lot of info to go by. The documentation must support the code. "History of indwelling cath" says to me that the patient had indwelling cath, no...
  43. O

    organic vs nonorganic ED

    In my opinion, if the doctor documents, for example, "erectile dysfunction. gave patient prescription for viagra." and no other info, I'd go with 607.84 erectile dysfuntion (organic origin) NOS. If the doctor specifically states that it is of nonorganic origin and/or links it with mental state...
  44. O

    organic vs nonorganic ED

    Published on: September 2004 Share | Related Articles0Comments Question: Which diagnosis code should I use for erectile dysfunction (ED)? Missouri Subscriber Answer: You should assign 607.84 (Other specified disorders of penis; impotence of organic origin) or 302.72 (Psychosexual...
  45. O

    organic vs nonorganic ED

    This article that I found on supercoder.com may be helpful to you. http://www.supercoder.com/articles/articles-alerts/fca/you-be-the-coder-how-to-differentiate-2-male-sexual-disorder-dxs/
  46. O

    Diagnosis code for Osteoarthritis

    I just wanted to point out that this is directly contradicted in the Ingenix Diagnoses Coders' Desk Reference/Guidelines for Coding and Reporting 2011 edition that I hold in front of me. Coding Scenario: A patient is seen in the office for a follow-up examination of her osteoarthritis in the...
  47. O

    Diagnosis code for Osteoarthritis

    I am familiar with the pasted coding clinic, however, I still stand by my original statement. To assign as localized without provider confirmation would be assumption coding. Very simply, it depends on the documentation. As we all know, coding is not so very black and white. If we were to always...
  48. O

    Dx help - Venous Distention

    This question was asked previously, so I'm just going to post the link and quote the answer. http://www.aapc.com/memberarea/forums/showthread.php?t=40219
  49. O

    Diagnosis code for Osteoarthritis

    I was taught that the doctor must distinguish between localized and generalized in his/her documentation to code it as such. If you look at your ICD-9 book, code 715.9X states "Osteoarthrosis, unspecified whether generalized or localized". We've all heard the saying that coders should never...
  50. O

    433.10 vs 433.30

    Interesting. This is something I did not know. I always just coded 433.30 for bilateral and 433.10 when it was not stated as bilateral. I've never coded both for the dx of bilateral carotid stenosis. Great info! Thanks, eadun2000! :D
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