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ICD-10 code for Post concussion syndrome

  1. Default ICD-10 code for Post concussion syndrome
    Medical Coding Books
    Our physicians have used IDC-10 code F07.81 as the primary diagnosis for patients presenting with post concussion syndrome. We have recently received denials from only United Healthcare when using the above code with the Remark Code being" An incorrect or inappropriate primary diagnosis code was used."
    When you look up F07 in the ICD-10 book it reads to code first the underlying physiological condition but when I convey this to the physician's they state that the post concussion syndrome is the condition for which they are treating the patient.
    Does anyone know how to handle ICD-10 and the diagnosis of post concussion syndrome? We seem to only be having this issue with United Healthcare, other insurance companies have processed F07.81 as the primary or only diagnosis.

  2. #2
    Columbia, MO
    You need to code the original head injury code with a 7th character S.

    Debra A. Mitchell, MSPH, CPC-H

  3. Default wondering if that worked with UHC
    I have a same denial with the primary dx of F07.81 but pt did not fall or any involvement in an accident. Could you also code the symptom or dizziness? Pt was seen for that previously. Pt also has UHC>

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