Wiki J01 and J05 codes requiring 2nd code

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kookykk

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As a PCP office we are having a hard time finding an appropriate code to apply as secondary code to Sinusitis and Croup. Per the ICD 10 diagnosis code book, J01 (Acute Sinusitis) and J05 (Acute obstructive laryngitis [croup] and epiglottitis) category of codes require a secondary/additional code (B95-B97) to identify the infectious agent. Many times our providers do not know the infectious agent, but the only unspecified code is B99.9 (Unspecified infectious disease) which falls outside of the code range listed in red in the book. (There are more code categories like this, but these two are most pertinent to our practice.) Does anyone have feedback on what they are using if the infectious agent is unknown? :confused:
 
An infectious condition, the provider may diagnosis without the support of any clinical information. This is appropriate and it is why even though you are instructed to add an organism you may submit without one. This is only for infections though.
 
So for the infection codes not in Chapter 1, that reference back to B95-B97 to identify the infectious agent...it is not required to have that infectious agent? Or should they just use B99.9 even though it is outside of the code range given in the book? I don't want to see denials, but I also don't want to code something we don't know. Thank you so much. kk
 
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