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BPH 600.00 vs 600.01

  1. Default BPH 600.00 vs 600.01
    Medical Coding Books
    Scenario: Male pt comes to PCP for annual PE w/ complaints of urinary urgency & frequency. He has tried a couple different BPH meds but none have been effective. Would this be coded to 600.00 or 600.01?

    My thinking: I was using 600.01 if the pt had controlled BPH symptoms on meds but then started having the symptoms return (a worsening of the condition). The urgency & frequency are part of the initial disease process and therefore should not be coded.

    What are your thoughts? I appreciate your time & help. Thanks much!

  2. #2
    Duluth, Minnesota
    just from what you've posted, I don't see where it states he has BPH at all. I only see urgency and frequency. You do state he's been on BPH meds, I'm not sure exactly what those are, but - are they used for other issues as well? (often meds are used for other than their primary reason because they've been found to help other issues - you know what I mean?). So, in short - unless it specifically states he has BPH without obstruction and LUTS (600.00) or BPH with obstruction and LUTS - I wouldn't code either ..
    I'd code the urgency 788.63 and frequency 788.41. big difference between BPH and urinary urgency or frequency....
    Donna, CPC, CPC-H

  3. Default
    Sorry I wasn't very clear. The dr gave dx of BPH. I coded 600.00 but the auditor is trying to tell me I should have coded 600.01. The record does not say what previous meds were tried, just that meds were tried in past without successful treatment. Hope this helps to clear up the situation/question.

  4. #4
    Duluth, Minnesota
    if the documentation supports BPH with LUTS (if the doctor specifically states the patient is having urgency & frequency)- I'd code it as such.
    Donna, CPC, CPC-H

  5. Default Bph with luts
    If the dr only documented BPH with obstruction, can i use 600.01 ?? if he never documented symptom , can i use that code ?

  6. Default 600.00 vs 600.01
    What if they only mention symptoms and no obstruction? Can I sill use 600.01?

    thank you

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