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    Question School Physicals

    Good morning! With the start of the school year, I am starting to see a few of the school physical visits in our urgent care clinic. I am wonder how everyone codes them. If it is stated as "school physical" in the assessment and there is no additional diagnosis, I use the E/M code and Z02.0...
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    Translation Services

    Hi! I need this information also. What I have been able to find so far, is that it probably will not be reimbursed. Sometimes, Medicaid (depending on the state) may pay, but Medicare (federal) won't. And as far as private payers go, I don't know. I found a brief article at...
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    Persistant Headache after a fall

    Hi! I don't know if I should use plain old R51 (headache) or a more specific code like G44.309 (Post traumatic headache, unspecified, not intractable) This patient fell while skiing a month ago and has had a persistent h/a on the right side of his head. The dr did order a CT scan, which I...
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    Workers Comp Coding

    Thank you Vickie! I just now saw that you replied to this question. Sorry I didn't see it sooner. Amy
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    Good morning! What is the opinion out there on "no sick contacts" counting as a component of the PFSH? I am coding for an urgent care center and right now we are at the height of URI, Bronchitis, Sinusitis and Flu season. The dr. always puts "no sick contact" or "+ sick contact" in his HPI...
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    Generic R or L Shoulder Tendonitis Help

    Good afternoon! I do coding for an urgent care facility and a small practice. Both seem to have their dx of "R shoulder tenonitis" or "L shoulder tendonitis". It is always vague. Should I use codes from M75.8 group or just put a generic M77.9 tendonitis code? With the M77.9 there is no...
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    Please help!

    Pam, Thank you so much!
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    Please help!

    Good morning! I am wondering if you can pull a dx code from Review of Systems and Exam, without it being mentioned in the CC, HPI or PFSH. Here is the encounter: "C/O sinus congestion/pressure x 1.5 weeks, +headache. Seen by PCP and Rx ZPak, (intelligible) x 5 days with some relief. States...
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    Vertigo assessment

    Hello! I'm a new coder and I think I know the answer to my own question, but I would just like a 2nd opinion. I am coding an urgent care visit. Diagnosis is otitis media, Pharyngitis and Vertigo. He has documented enough for the OM and pharyngitis, but there is really nothing to support the...
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    Workers Comp Coding

    Good morning! I am having a problem figuring out how to code a workers comp claim. This is my first coding job and this one has me stumped. A woman cut her finger with scissors while working at a salon (Sports Clips). She had a small, simple closure laceration, under 2.5 cm. Here are the...