Wiki A Tick Is Not An Insect!

[dgunn]

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]

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]

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.

diagnosis codes, diagnosis coding

 

[Marianne614]

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

diagnosis codes, diagnosis coding

 

[dgunn]

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.

This is what I needed. Thank you!

diagnosis codes, diagnosis coding

 

[chembree]

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.

diagnosis codes, diagnosis coding

 

[thomas7331]

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.

diagnosis codes, diagnosis coding