Wiki B96.1

[david.jaime@sonoraquest.com]

Why are some payors noting B codes ,without instructional notes advising that an additional organism code as required , as never being able to be used as a primary dx for procedure? While it is true some unspecified codes in the B95-B97 series may require additional codes to identify infectious agents . There are some B codes in that range (B96.1 for example) which do not have any restrictions related to being primary and have the highest specificity based on bacteria being indicated on code itself in green font as a code descriptor. Therefore, not certain why it is being denied as not being able to be primary? What am I missing? Thank you

 

[thranowski]

In the guidelines it says for B95, B96, or B97 they are to be used as additional codes to identify the organism. They can't be used as primary diagnosis codes.

 

[thomas7331]

Agreed, per the ICD-10 section notes for B95-B97: These categories are provided for use as supplementary or additional codes to identify the infectious agent(s) in diseases classified elsewhere. That 'disease classified elsewhere' must be coded first. The codes in this range can never be primary