Wiki T50.905A

[Michael0630]

Quick question,

My allergist saw a patient using diagnosis T50.905A (Adverse effect of unspecified drugs, medicaments and biological substances, initial encounter) and the insurance is stating that this cannot be used as a primary diagnosis. I read the guidelines and there is nothing there (that I can find) stating that adverse effects cannot be primary codes.

I would like to know what others think about this.

I thank you in advance.

 

[LisaAlonso23]

The primary code should be the nature of the adverse effect followed by the code for the adverse effect (ie, T50.905A) per the guidelines.

 

[Michael0630]

The primary code should be the nature of the adverse effect followed by the code for the adverse effect (ie, T50.905A) per the guidelines.

Thank you!

Another question, I just looked at the providers note and the patient stated she had "flu like symptoms" from being on nitrofurantoin. Would that be the "nature"? How exactly would I code this? Would it be T37.8X5A?

Thank you so much in advance.


Here is a snip of the note -

Per patient she has had history of urinary tract infections (approx 1-3x/year needing antibiotics). These UTIs had been responsive to ciprofloxacin. 3-4 years ago, she was started on a regimen of taking ciprofloxacin after intercourse and has not had any UTIs while on this regimen. Last May her urologist recommended that she stop this regimen. However subsequently when she was treated with keflex, the symptoms only transiently resolved with quick recurrence of symptoms, until ultimately eradicated when given ciprofloxacin.

2 weeks ago she had dysuria and burning sensation and urine culture grew E Coli. She was given keflex for 7 days and is now asymptomatic.

Her urologist ideally would like to give nitrofurantoin 100mg or Bactrim DS (1 pill) for UTIs.

However patient recalls having "flu like symptoms" on two occasions days after receiving one of the above antibiotics, and has been avoiding both since.

Delayed flu-like symptoms to either nitrofurantoin or Bactrim are not characteristic of IgE mediated symptoms that would be concerning for anaphylaxis. It is unclear whether those symptoms are coincidental or considered adverse side effects. However, per urologist's request, she would like us to clarify that these medications are not concerning hypersensitivity reaction and does not present as risk for anaphylaxis

 

[sls314]

Thank you!

Another question, I just looked at the providers note and the patient stated she had "flu like symptoms" from being on nitrofurantoin. Would that be the "nature"? How exactly would I code this? Would it be T37.8X5A?

Thank you so much in advance.


Here is a snip of the note -

Per patient she has had history of urinary tract infections (approx 1-3x/year needing antibiotics). These UTIs had been responsive to ciprofloxacin. 3-4 years ago, she was started on a regimen of taking ciprofloxacin after intercourse and has not had any UTIs while on this regimen. Last May her urologist recommended that she stop this regimen. However subsequently when she was treated with keflex, the symptoms only transiently resolved with quick recurrence of symptoms, until ultimately eradicated when given ciprofloxacin.

2 weeks ago she had dysuria and burning sensation and urine culture grew E Coli. She was given keflex for 7 days and is now asymptomatic.

Her urologist ideally would like to give nitrofurantoin 100mg or Bactrim DS (1 pill) for UTIs.

However patient recalls having "flu like symptoms" on two occasions days after receiving one of the above antibiotics, and has been avoiding both since.

Delayed flu-like symptoms to either nitrofurantoin or Bactrim are not characteristic of IgE mediated symptoms that would be concerning for anaphylaxis. It is unclear whether those symptoms are coincidental or considered adverse side effects. However, per urologist's request, she would like us to clarify that these medications are not concerning hypersensitivity reaction and does not present as risk for anaphylaxis

For nitrofurantoin, T37.8X5A would be appropriate according to the Table of Drugs and Chemicals.

Was there any more specificity about what the "flu like symptoms" were? Ex - fever, cough, sore throat, diarrhea, runny nose, etc. (Whatever types of symptoms a person might mean when they say the vague "flu like symptoms.")

If you have a specific symptom, I'd use the symptom code for that.

 

[Michael0630]

For nitrofurantoin, T37.8X5A would be appropriate according to the Table of Drugs and Chemicals.

Was there any more specificity about what the "flu like symptoms" were? Ex - fever, cough, sore throat, diarrhea, runny nose, etc. (Whatever types of symptoms a person might mean when they say the vague "flu like symptoms.")

If you have a specific symptom, I'd use the symptom code for that.

Unfortunately not, that is all the patient told the provider . Would coding it as a UTI be incorrect?

 

[LisaAlonso23]

Thank you!

Another question, I just looked at the providers note and the patient stated she had "flu like symptoms" from being on nitrofurantoin. Would that be the "nature"? How exactly would I code this? Would it be T37.8X5A?

Thank you so much in advance.


Here is a snip of the note -

Per patient she has had history of urinary tract infections (approx 1-3x/year needing antibiotics). These UTIs had been responsive to ciprofloxacin. 3-4 years ago, she was started on a regimen of taking ciprofloxacin after intercourse and has not had any UTIs while on this regimen. Last May her urologist recommended that she stop this regimen. However subsequently when she was treated with keflex, the symptoms only transiently resolved with quick recurrence of symptoms, until ultimately eradicated when given ciprofloxacin.

2 weeks ago she had dysuria and burning sensation and urine culture grew E Coli. She was given keflex for 7 days and is now asymptomatic.

Her urologist ideally would like to give nitrofurantoin 100mg or Bactrim DS (1 pill) for UTIs.

However patient recalls having "flu like symptoms" on two occasions days after receiving one of the above antibiotics, and has been avoiding both since.

Delayed flu-like symptoms to either nitrofurantoin or Bactrim are not characteristic of IgE mediated symptoms that would be concerning for anaphylaxis. It is unclear whether those symptoms are coincidental or considered adverse side effects. However, per urologist's request, she would like us to clarify that these medications are not concerning hypersensitivity reaction and does not present as risk for anaphylaxis

According to the last paragraph second sentence, you cannot code an adverse reaction to nitrofuantoin. It specifically states that it's unclear if the patient had an adverse reaction or if the flu-like symptoms were coincidental.