09-21-2017, 02:53 AM | Community Wiki

Results 1 to 6 of 6

Resolved Otitis Media

  1. Default Resolved Otitis Media
    Exam Training Packages
    How are you billing the diagnosis for Otitis Media - Resolved? The patient has no other symptoms to code. The only ICD10 code that seems appropriate is Z09, however insurance companies are denying the office visit when that code is the only one used. Any suggestions?

  2. Default
    Quote Originally Posted by tina49ers80 View Post
    How are you billing the diagnosis for Otitis Media - Resolved? The patient has no other symptoms to code. The only ICD10 code that seems appropriate is Z09, however insurance companies are denying the office visit when that code is the only one used. Any suggestions?

    What about leading with a follow up Z code and then the OM? Z09 = Encounter for follow up exam after completed treatment for conditions other than malignant neoplasm.

    Just a thought. Good luck

  3. Default
    Quote Originally Posted by ehanna View Post
    What about leading with a follow up Z code and then the OM? Z09 = Encounter for follow up exam after completed treatment for conditions other than malignant neoplasm.

    Just a thought. Good luck
    Or leading with the OM and then the follow up Z code

  4. #4
    Location
    Columbia, MO
    Posts
    12,892
    Default
    Z09 is correct and you would not code for a condition that no longer exists. The question is was this a follow up exam or was it an exam for otitis media? If the patient had otitis media and returned for a recheck then it was not known to have resolved at the time of the encounter so code only the Otitis media. If however it was known to have resolved and this is a follow up visit to be sure there are no issues then the Z09 is correct. Coding clinics have visited this issue many times and have applied this logic for infection recheck encounters.

    Debra A. Mitchell, MSPH, CPC-H

  5. Default
    Thank you both for this information. The visit is for a recheck/follow up and it has been determined that the ear infection is no longer present. My thoughts were to use both the ICD10 code for OM & the Z09, which would clarify that it has now resolved. But, since the OM has resolved that diagnosis really shouldn't be coded. Not sure why the insurance companies will not pay for the visit with just the Z09. Thank you again!!

  6. #6
    Location
    Houston Local Chapter
    Posts
    119
    Default
    Quote Originally Posted by mitchellde View Post
    Z09 is correct and you would not code for a condition that no longer exists. The question is was this a follow up exam or was it an exam for otitis media? If the patient had otitis media and returned for a recheck then it was not known to have resolved at the time of the encounter so code only the Otitis media. If however it was known to have resolved and this is a follow up visit to be sure there are no issues then the Z09 is correct. Coding clinics have visited this issue many times and have applied this logic for infection recheck encounters.

    thank you for this - very helpful!
    Ronna Foster, CPC, CMC, CMIS

Similar Threads

  1. Resolved otitis media
    By coorbeck in forum Pediatrics
    Replies: 2
    Last Post: 10-07-2015, 08:42 AM
  2. Resolved Otitis Media ICD-9 code
    By sctaylor in forum Pediatrics
    Replies: 1
    Last Post: 12-17-2014, 12:30 PM
  3. Otitis Media w Otitis Externa???
    By elizabeth24 in forum Diagnosis Coding
    Replies: 2
    Last Post: 02-25-2014, 11:23 AM
  4. Replies: 2
    Last Post: 03-10-2011, 12:50 PM
  5. Recurrent acute otitis media, right purulent otitis media with effusion
    By jwschroeterjr@gmail.com in forum Diagnosis Coding
    Replies: 5
    Last Post: 02-07-2011, 01:35 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.