Wiki hyperplasia of tonsils

[buppkl]

When a path report states tonsils showing follicular hyperplasia consistent with chronic tonsillitis, would you choose the code for hyperplasia of tonsils or chronic tonsillitis or both?

 

[bbooks]

Since it says "consistent with" I would most likely code just for the chronic tonsillitis. If it said something like "hyperplasia and chronic tonsillitis" I would code for both.

 

[psacco]

consistent with

I would code for the follicular hyperplasia.... it is saying that the follicular hyperplasia is "consistent with" chronic tonsillitis...per guidelines, we do not bill for "consistent with" or "compatible with" dx... the pathologist is not sure, just saying that the follicular hyperplasia acts like chronic tonsillitis....

 

[bbooks]

Good points. However, Padget indicates that a "consistent with" diagnosis usually can be considered conclusive, as long as the pathologist makes no documentation to the contrary. This is different from statements like "suspicious for," "probable," and "likely." In any case, if there are questions, it's best to consult with your pathologist. I had a discussion about such statements from my pathologists and received some useful guidelines. My pathologists often used "favorable for" and instructed me that I could code definitively from that statement.