Wiki Depression/Anxiety - ICD-9 and E/M

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MnTwins29

MnTwins29

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Hi: I can't seem to find anything specific in any coding guidelines concerning when to use the two separate codes for these conditions (311 and 300.00 respectively) and when to use the combined code of 300.4. I have documenation treating as two separate conditions, but they are tied in the same treatment plan. This would also affect the MDM in the E/M assignment as if it is one or two chronic conditions. Any thoughts?
 
I was trained to only code 300.4 "Dysthymic disorder" when the documentation states depression with anxiety. If these are not stated as such, to code them separately. Unfortunately, I do not have a reference for you other than the description of the ICD-9 code itself. :)
 
Coding Clinic, Thrid Quater 2011
Assign codes 311, Depressive disorder NEC, and 300.00, Anxiety state, for a diagnostic statement of depression and anxiety. Code 300.4, Dysthymic disorder, is not appropriate since the provider has not established a linage between the two conditions. When there is no association between the two conditions, assign separate codes. If however the provider documents depression with anxiety, assign code 300.4, Dysthymic disorer.
 
Question:

What is the code assignment for depression and anxiety?

Answer:

Assign codes 311, Depressive disorder NEC, and 300.00, Anxiety state, unspecified, for a diagnostic statement of depression and anxiety. Code 300.4, Dysthymic disorder, is not appropriate since the provider has not established a linkage between the two conditions. When there is no association between the two conditions, assign separate codes.

If, however, the provider documents depression with anxiety, assign code 300.4, Dysthymic disorder.

as per AHA
 
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