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Excludes 1 note for R40-R46

  1. #1
    Pensacola, Florida
    Default Excludes 1 note for R40-R46
    Medical Coding Books
    Codes from this section have an excludes 1 note stating 'symptoms and signs constituting part of a pattern of mental disorder (F01 - F99)'

    For instance - the patient has Borderline intellectual functioning (R41.83); and Depression - F32.9. The Provider does not state one is part of the other.

    So in this scenario I would only code whichever one the Provider listed as the primary Dx, correct?

    Thanks for any feedback!
    Bridgette Martin LPN, CPC, CEMC, CGIC

  2. #2
    Columbia, MO
    F32.9 is the code for major depressive disorder unspecified. This is not the same as describing an unhappy patient as depressed. Unhappiness is R45.2. An excludes 1 not does indicate that the two codes cannot be use together, so only one may be selected. However if the provider meant unhappiness then you can code both the R41.83 and the R45.2.
    In this case because it is an excludes 1 note the provider does not need to link the symptom to the mental dx, you may still code only one, and that would generally be the underlying definitive dx or in this case the major depressive disorder.

    Debra A. Mitchell, MSPH, CPC-H

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