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tdxhounds

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I have patients with a cough that are RSV positive. What ICD 10 code or codes would you use? The cough with B37.4 ?? or is there a code for RSV only that I am missing?
 
I think you mean B97.4, not B37.4? But the answer here is going to depend on what the provider has documented. B97.4 is for RSV as the cause of diseases classified elsewhere, which would require documentation that the RSV was the cause of the cough - you can't presume that a positive test means that this is the case. There's no ICD-10 code for just a positive RSV test - the provider does need to confirm the RSV diagnosis and document that this is cause of the cough or other condition which the provider has diagnosed.
 
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thomas7331 said:
I think you mean B97.4, not B37.4? But the answer here is going to depend on what the provider has documented. B97.4 is for RSV as the cause of diseases classified elsewhere, which would require documentation that the RSV was the cause of the cough - you can't presume that a positive test means that this is the case. There's no ICD-10 code for just a positive RSV test - the provider does need to confirm the RSV diagnosis and document that this is cause of the cough or other condition which the provider has diagnosed.
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oops typo ... yes B97.4. there is no such documentation. The patient simply came in with a cough and the RSV test was positive. I am guessing I can just code the signs and symptoms? I can't find a code for a positive test like a positive strep or any other positive test . B97.4 is the only RSV dx . The others are for actual pneumonia RSV , etc.
 
tdxhounds said:
oops typo ... yes B97.4. there is no such documentation. The patient simply came in with a cough and the RSV test was positive. I am guessing I can just code the signs and symptoms? I can't find a code for a positive test like a positive strep or any other positive test . B97.4 is the only RSV dx . The others are for actual pneumonia RSV , etc.
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Yes, as per the guidelines, code the signs and symptoms if your provider hasn't given you a definitive diagnosis.

I wouldn't code any diagnosis based on a positive test, even if you can find a code. A positive test doesn't mean that the physician is giving the patient that diagnosis (e.g. I've seen situations where the physician feels the test is a false positive or doesn't agree with the test results). You can only assign a code based on the provider's assessment, whether it's RSV or strep or anything else. The only exception to this that I've encountered has been with COVID, where in some cases specific written guidance has been given that allows the assignment of the code when a positive test is documented.
 
thomas7331 said:
Yes, as per the guidelines, code the signs and symptoms if your provider hasn't given you a definitive diagnosis.

I wouldn't code any diagnosis based on a positive test, even if you can find a code. A positive test doesn't mean that the physician is giving the patient that diagnosis (e.g. I've seen situations where the physician feels the test is a false positive or doesn't agree with the test results). You can only assign a code based on the provider's assessment, whether it's RSV or strep or anything else. The only exception to this that I've encountered has been with COVID, where in some cases specific written guidance has been given that allows the assignment of the code when a positive test is documented.
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Thank you for the help. The provider did diagnosis the patient with RSV and is treating it as such. It is not just me coding from a test result. Sorry , I am not trying to be difficult. :) I may just have to code symptoms
 
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