Normal Newborn

msbrowning

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Please help, I am having a hard time with this one:

2 week old baby bought into the office, mother states that baby cries all the time and won't eat. Doctor examines infant and finds nothing wrong and gives a dx of normal newborn.

I coded this as 780.92 excessive crying in an infant and 307.59 other disorders of eating (infantile feeding disturbances of nonorganic origin)

Am I correct?
 

dmaec

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if the doctor didn't find anything wrong with the child, I'd be coding either "feared complaint unfounded" or - "well child" - I wouldn't be coding any issues if the doctor found everything to be "normal".
{that's my opinion on the posted matter}
 

msbrowning

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Ok thank you. I was under the impression that if no diagnosis is found, I am to code the CC or symptoms.
 
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feared complaint

I'd code the feared complaint and the excessive crying.

It wasn't a well-child visit so I wouldn't code "well child"

Just my opinion.

F Tessa Bartels, CPC, CPC-E/M
 

bhaskins1

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I was just having this conversation with one of my Doctors yesterday. If there is no diagnosis but there is a symptom to code... code the symptom. I only use V65.5 "worried well" as a last resort because some commercial carriers will deny. I would however talk to the Doctor first before I coded something like 307.59 other disorders of eating (infantile feeding disturbances of nonorganic origin)... From the info you have given I'm not sure this code would apply. It's more of a diagnosis than a symptom. Also... Well Child would definitely not apply here... V20.2 should only be used for preventative exams.
 

ARCPC9491

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I would code signs/symptoms.. it's not a well visit, the patient didn't come in for a well child, and as previously stated, many insurances would reject anyway.. or make the patient responsible for something that was incorrect
 

okiesawyers

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I would not use 307.59 without further clarification from the provider. This code is in the mental health section and should be used with caution in the case of children!
 

EARREYGUE

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We were told in our office by our compliance dept. that V65.5 can not be a primary dx, so I would do the symptoms and use code 780.92 and V65.5. However if the doctor is writting normal visit, in our office we use V71.89 Observation and Evaluation for other specified suspected conditions not found. Just my thoughts
 

dmaec

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just to clarify a little; :) I was going by the post "Doctor examines infant and finds nothing wrong and gives a dx of normal newborn.". So, I would more than likely use the feared complaint unfounded code (V65.5), since the doctor did not find anything wrong with the child and gave a dx of "normal newborn". I'm assuming the provider is charging an E/M level (not a preventive service). This may or may not be paid my insurance. According to the V-code table in the front of the ICD-9 book, V65.5 CAN be used as primary (or secondary) code. I mentioned using the V20.2, probably not a good choice. (thanks for pointing that out) ;)

k..that being said - IF documentation supports a crying baby, then perhaps I'd code that primary with the feared complaint secondary. and, I wouldn't touch the 3xx.xx code! not at this point in the newborns life! ...
 

MJ4ever

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I wanted to point out, that if it is a 2 week old baby; for feeding problems, I would use 779.3, not 783.3.
Also, if the baby had excessive crying, I would have used 780.92 as primary and feeding problems (779.3) secondary.

Be interesting to find which dx the insurance would really cover...
 
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