Wiki physical therapy coding question?

Create Wiki Sort by votes
S

sherrygalla

Contributor
Messages
13
Best answers
0
Good morning ~ we have a patient who contracted bacterial pneumonia due to contact with mold at her work. She then had muscle weakness due to the pneumonia and sought physical therapy to regain strength. I wanted to make sure I coded this correctly as it is workers comp. Coding:
M62.81 (muscle weakness)
Z77.120 (exposure to mold)
Z09 (encounter for follow-up exam)
Z87.09 (personal hx of other diseases of respiratory system)
J16.8 (pneumonia due to other specified infectious organisms)

Do these codes look correct and in the correct order? Thank you for any help!
 
0
sherrygalla said:
Good morning ~ we have a patient who contracted bacterial pneumonia due to contact with mold at her work. She then had muscle weakness due to the pneumonia and sought physical therapy to regain strength. I wanted to make sure I coded this correctly as it is workers comp. Coding:
M62.81 (muscle weakness)
Z77.120 (exposure to mold)
Z09 (encounter for follow-up exam)
Z87.09 (personal hx of other diseases of respiratory system)
J16.8 (pneumonia due to other specified infectious organisms)

Do these codes look correct and in the correct order? Thank you for any help!
Click to expand...

Does the patient still have pneumonia? I see that you're using a history of respiratory disease code - is that referencing the pneumonia, and if so why are the active and history being coded together?
 
0
Sherry
Always code Z dx codes last if not first listed dx codes. The ICD10 manual tells you which are first and which are last Z dx codes. Do not leave out J code. I d use the muscle weakness then J code and Z09. .Ahh what does workers comp has as the reason she came in...was this not preauthorized?Most WC want same dx as problem worker suffers with.
I hope helped you.
Lady T
 
0
As stated by Lady T, you would have to use the diagnosis/problem that WC is covering. If you submit with a problem that they do not have has covered, it won't go through.
Also, when it comes to physical therapy, what is the reason or symptom the patient is being seen specifically for physical therapy, it's not pneumonia, it's muscle weakness.
Did the WC carrier approve physical therapy, is it authorized? You're statement that, "she sought physical therapy to regain strength" sounds like she decided on her own to do it. Just some thoughts that come to mind when dealing with WC.
Z09 doesn't make a whole lot of sense as well as the J16.8.

What does the therapist's documentation state?
 
0
TThivierge said:
Sherry
Always code Z dx codes last if not first listed dx codes. The ICD10 manual tells you which are first and which are last Z dx codes. Do not leave out J code. I d use the muscle weakness then J code and Z09. .Ahh what does workers comp has as the reason she came in...was this not preauthorized?Most WC want same dx as problem worker suffers with.
I hope helped you.
Lady T
Click to expand...
 
0
Thank you everyone for your responses. I did end up calling the Department of Labor and the provider was off on his diagnosis. I have corrected it now. I appreciate all of your help!
 
0
PSpraveen2022 said:
Your codes look mostly correct, but here's a quick breakdown:

  1. M62.81 (Muscle Weakness): Correct for weakness due to pneumonia.
  2. Z77.120 (Exposure to Mold): Appropriate for mold exposure at work, leading to pneumonia.
  3. Z09 (Follow-Up Exam): Fine for a follow-up visit.
  4. Z87.09 (Personal History of Respiratory Disease): Correct if the patient has a history of respiratory issues.
  5. J16.8 (Pneumonia due to Other Specified Infectious Organisms): Correct for pneumonia caused by mold.

Correct Order:​

  • J16.8 (primary condition)
  • M62.81 (muscle weakness)
  • Z77.120 (mold exposure)
  • Z87.09 (personal history)
  • Z09 (follow-up)
If you're ever unsure about the codes or their order, CodeBooks can streamline the process. With AI-powered code lookup and up-to-date guidelines, it ensures accuracy and saves you time, especially for complex cases like this. I have been using this tool for coding and it has helped me reduce coding errors and helped save time and efforts, I am providing you the link for your reference. https://codebooks.rapidclaims.ai/
Click to expand...
Respectfully disagree, this is a physical therapy service in question. The primary condition being treated would not be pneumonia.
Again, also due to it being WC, they would have to use the diagnosis/problem that WC is covering and for which authorization was received.
When it comes to physical therapy, what is the reason or symptom the patient is being seen specifically for physical therapy?
 
You must log in or register to reply here.
Top