Wiki A Tick Is Not An Insect!

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B
Code: W57
Bitten or stung by nonvenomous insect and other nonvenomous arthropods
Excludes 1: contact with venomous insects and arthropods (T63.2-, T63.3-, T63.4-)

Category Notes
Exposure to animate mechanical forces (W50-W64)
Excludes 1: Toxic effect of contact with venomous animals and plants (T63.-)

Coding Guidelines
External causes of morbidity (V00-Y99)
Note: This chapter permits the classification of environmental events and circumstances as the cause of injury, and other adverse effects. Where a code from this section is applicable, it is intended that it shall be used secondary to a code from another chapter of the Classification indicating the nature of the condition. Most often, the condition will be classifiable to Chapter 19 , Injury, poisoning and certain other consequences of external causes (S00-T88). Other conditions that may be stated to be due to external causes are classified in Chapters I to XVIII. For these conditions, codes from Chapter 20 should be used to provide additional information as to the cause of the condition.

dgunn

Contributor
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W57.XXXA should be the appropriate code for a tick bite, but payers are not paying as a primary dx. Technically a tick is an arthropod and not an insect (because it has 8 legs and not 6.) For this reason, I have been hesitant to use a different code (such as the S codes for insect bite.) If rash is documented, I have listed that as the primary followed by the W57 code.

Any suggestions on what to do if 'Tick bite' is both the symptom and diagnosis - that is if rash or edema is not documented?

Thanks
 

thomas7331

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I've always felt that treatment for a tick bite is not actually for the bite itself but for the suspected exposure to the diseases that it carries, so if the provider documents that as the reason, I could suggest you could try using Z20.818 for 'contact with and (suspected) exposure to other bacterial diseases'. Not sure whether or not that would help from a payment standpoint.
 

mitchellde

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W57.XXXA should be the appropriate code for a tick bite, but payers are not paying as a primary dx. Technically a tick is an arthropod and not an insect (because it has 8 legs and not 6.) For this reason, I have been hesitant to use a different code (such as the S codes for insect bite.) If rash is documented, I have listed that as the primary followed by the W57 code.

Any suggestions on what to do if 'Tick bite' is both the symptom and diagnosis - that is if rash or edema is not documented?

Thanks

Codes that begin with V, W, X, or Y ( chapter 20) can never be used as principle diagnosis codes. You can use the S40.- code for superficial bite as the first listed code.
 

Marianne614

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Tick Bite

I've always felt that treatment for a tick bite is not actually for the bite itself but for the suspected exposure to the diseases that it carries, so if the provider documents that as the reason, I could suggest you could try using Z20.818 for 'contact with and (suspected) exposure to other bacterial diseases'. Not sure whether or not that would help from a payment standpoint.

I absolutely agree with you. That is a great code for that encounter.

Thanks again.

Marianne CPC
 

chembree

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I've always felt that treatment for a tick bite is not actually for the bite itself but for the suspected exposure to the diseases that it carries, so if the provider documents that as the reason, I could suggest you could try using Z20.818 for 'contact with and (suspected) exposure to other bacterial diseases'. Not sure whether or not that would help from a payment standpoint.

I don't think you can assume the reason they are seeking treatment unless stated. It could be infected or many other reasons. I would only code what is documented.

I agree with Debra's response.
 

thomas7331

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I don't think you can assume the reason they are seeking treatment unless stated. It could be infected or many other reasons. I would only code what is documented.

I agree with Debra's response.


I agree that you have to use what's documented. But it's usually the case that the patient is being seen and treated for the potential infection - the bite injury itself is not usually serious in and of itself. If the provider documents that they prescribing an antibiotic for a tick bite and not stating the rationale that it's either for an active infection or for a prophylaxis to prevent an infection, then there's an opportunity for education and improvement of their documentation.
 
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