Wiki DX H04.552

[Lungaro]

Billed 99213 W/DX of H04.552 on a 3 week 6 day old. Ins is rejecting. Is there a better code?

 

[sls314]

Billed 99213 W/DX of H04.552 on a 3 week 6 day old. Ins is rejecting. Is there a better code?

That's the code for acquired stenosis of the left nasolacrimal duct.

Since the child is less than a month old, it would seem more likely that the congenital diagnosis would be more appropriate.

If you look at the Excludes notes for the HO4.- category, you'll see that there's an Excludes1 note for Congenital malformations of lacrimal system (Q10.4-Q10.6). That should help direct you to finding the correct code for the patient's condition.