kmdnine
Contributor
I code family medicine well child visits, and I often encounter situations, where the provider is addressing the child's resolving neonatal nasolacrimal duct obstruction. Typically, it will be about 5 weeks out, and the obstruction is on the child's active problem list. I change the providers dx code of H04.53* to Q10.5, in order to resolve the age discrepancy edit. My auditor gave me a hit for using Q10.5 versus H04.55*. I am told I am to code it this way, because the provider didn't specifically state it was congenial. My response was that H04.53* is congenital by nature, thus Q10.5 can be inferred in this case. Any thoughts?