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adw9111

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We recently had a patient come in for an ulcer follow up. The doctor charged a 99212 for the visit. The doctor noted that the ulcer was healed, trimmed some callous tissue and counseled the patient some on his edema. The diagnosis codes in the note were 707.15 ulcer, 250.00 diabetes, and 703.8 disease of nail. I have no idea why the 703.8 was in the assessment but when I queried the doctor to add the corns/callous diagnosis (700) and the edema (782.3) he stated that since the patient only came in for the ulcer follow up, (not his edema or callouses) all I would need to use is the ulcer as the diagnosis for the OV. This is not what I had thought was correct coding, (granted I just got my certification) but should I not code the OV with diagnosis codes 707.15, 700, 782.3, and then 250.00??? I thought that you should code each diagnosis on an OV that the patient either presented with or had treated. Any help would be greatly appreciated....
 
Coding of the DX

The Dr. is correct you should only code the reason for the visit and the current condition. If the Dr. did not state that the diseased nail was separate as a dx then it's not coded. Only code the current dx that the patient is being treated for at the time of service. :) I'm new as a coder and currently in the process of looking for a job in the field. Congratulations :)
 
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