Wiki Help with CPT & diagnosis codes

[mrolf]

When a patient is seen in the clinic for a cough and the doctor decided to give the patient a Rocephin injection after an evaluation. How would you bill out and what diagnosis would you match to each code? I have been told by an office biller that you would code it this way.



99213 – 25 with dx code 786.2

J0696 – with dx code 486

96372 – with dx code 486



I keep feeling like this is wrong since coding guidelines tell you to never code the symptom that is related to the diagnosis. Please let me know how others feel about doing this…Do other coders/billers receive payment in this scenario with the same diagnosis on each line item. Thxs!

 

[btadlock1]

When a patient is seen in the clinic for a cough and the doctor decided to give the patient a Rocephin injection after an evaluation. How would you bill out and what diagnosis would you match to each code? I have been told by an office biller that you would code it this way.



99213 – 25 with dx code 786.2

J0696 – with dx code 486

96372 – with dx code 486



I keep feeling like this is wrong since coding guidelines tell you to never code the symptom that is related to the diagnosis. Please let me know how others feel about doing this…Do other coders/billers receive payment in this scenario with the same diagnosis on each line item. Thxs!

You're correct. The diagnosis code should be 486 on all 3 - 786.2 is an integral part of the disease, so it's not reported. Your CPT codes are perfect...Good job!