Results 1 to 6 of 6

Botox diagnosis coding

  1. Default Botox diagnosis coding
    Exam Training Packages
    I need some help in coding the following scenario. There is a discrepancy at our facility on how the diagnosis for this patient should be coded

    Pt was sent to our facility with an order to have Botox with accompanying diagnosis of muscle spasm and spastic L hemiparesis due to CVA.

    Procedure note states The patient is a ___year old female with spastic left hemiparesis due to a CVA.

    Any help with this would be greatly appreciated.

  2. #2
    Default
    maybe try the late effect of CVA codes. They have a list of conditions caused by the CVA for almost everything. Is that what you meant or did you mean a procedure code?

  3. Default
    Leslie,
    You hit the nail on the head. The division is whether it should be coded to the late effects or can you code the muscle spasm seperately.
    Any further thoughts

  4. #4
    Location
    Columbia, MO
    Posts
    12,557
    Default
    If he documents that it is due to the CVA then you must code with a 438 code for the late effect of the CVA, and you do not code the muscle spasm. Per the coding guideliens late effects must have 2 codes except CVA late effects which are coded as a 438.x

    Debra A. Mitchell, MSPH, CPC-H

  5. #5
    Location
    Sioux Falls South Dakota
    Posts
    358
    Default
    If this is a Medicare patient, however, you will need to check for an LCD for chemodenervation/botox. Our carrier, Noridian, wants us to use the spasticity code along with a second diagnosis code - they are all listed in the LCD. The late effects of CVA are not among the codes that can be used alone.

    Cindy Mc
    CPC-P

  6. #6
    Location
    Columbia, MO
    Posts
    12,557
    Default
    The LCD cannot override the coding guidelines for ICD-9. The physician documents this as a late effect of the CVA and that is how it must be coded we cannot change just for payment.

    Debra A. Mitchell, MSPH, CPC-H

Similar Threads

  1. Wiki Need Help Coding Botox Injection
    By carrollalicia1 in forum Anesthesia
    Replies: 9
    Last Post: 01-17-2017, 07:52 AM
  2. outpatient coding for diagnosis vs diagnosis
    By rkeia32 in forum Resume Postings
    Replies: 1
    Last Post: 07-11-2015, 08:44 PM
  3. Botox - What is the difference
    By chrissylyman0629@gmail.com in forum Ophthalmology/Optometry
    Replies: 1
    Last Post: 03-20-2013, 12:55 PM
  4. Botox - I have a medicare patient
    By sc5399@gmail.com in forum Billing/Reimbursement
    Replies: 2
    Last Post: 08-09-2012, 03:31 PM
  5. Help coding Botox
    By healthsoukcoders in forum Employment General Discussion
    Replies: 2
    Last Post: 06-16-2011, 10:52 AM

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.