Additional codes required?

chenson384

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We are having difficulty getting the information from our physicians for the "additional codes" and "code first" instructions in the ICD-9 manual. We are finding we have to just file without an additional code. Is anyonoe else having this problem? At this point, insurance companies are paying the most of these without these first or additional codes, so is this required or only suggested if the applicable information is available?
An examples: Cellulitis codes: 682._(used addition code to identify organism) or Diabetes with neurological manifestations 250.6_( use additional code to identify manisfestation)
 

apotteiger

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secondary diagnoses

In the case of the cellulitis the additional code is only required if the organism is known. If a culture was not done prior to antibiotic therapy, the organism may not be known and therefore there is no additional code to be reported.

In diabetic coding, the neurologic manifestation should be known. If it is not documented, I would query the physician for more information.
 

chenson384

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so since this is not required with cellulitis if the organism is not known, does that mean the notation in ICD-9 to code additional for all codes --- is NOT REQUIRED, just suggested?
 

apotteiger

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additional code

I wouldn't term any "use additional code" note in the ICD-9-CM as only a suggestion. If you know the information, it is mandatory to report it. However, many infections are treated with a broad spectrum antibiotic rather than performing a culture, so the exact organism is not known making it impossible to assign an additional code.
 
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