AAPC - Back to school
Results 1 to 6 of 6

Thread: Diagnosis code for rule out crohn's

  1. #1

    Cool Diagnosis code for rule out crohn's

    AAPC: Back to School
    I know that there are no codes for rule out however the patient came in and had a capsule endoscopy as she is suspected of having crohn's and with medicare you are only allowed to bill for certain diagnosis codes in order for the test to be paid. We have used 793.4 as she had some abnormal findings on her ct scan and this is one of the codes payable by Medicare but I still need a primary code to use with this one. Does anyone have any suggestions? I dont think I can use the 555.9 as she hasnt been diagnosed with crohn's yet. Thanks.

  2. #2
    Join Date
    Apr 2007


    I'm guessing that the patient must have some signs or symptoms to suspect the Chrons?

  3. #3


    Yes he is checking for inflammation she has been having epigastric pain on and off and she has had an EGD with polyps in the stomach that were benign.

  4. #4


    Then I would use the 789.06 as it is the reason for the study. Just my opinion.

  5. #5
    Join Date
    Apr 2007


    I would go with the signs or symptoms too.

  6. #6


    I used to use teh signs or symptoms unless the pt had another diagnosis that led to the study like abd pain
    adrianne, cpc

Similar Threads

  1. OPPS Procedure code Bundling Rule
    By fannieaapc in forum Medicare Regulations
    Replies: 0
    Last Post: 03-17-2014, 10:26 AM
  2. changing diagnosis code on claim when secondary denies the diagnosis code
    By taj0257@msn.com in forum Billing/Reimbursement
    Replies: 3
    Last Post: 09-27-2013, 10:00 AM
  3. Coding Rule for Diagnosis.
    By Marla K in forum OB/GYN
    Replies: 1
    Last Post: 06-04-2012, 09:15 PM
  4. unlisted procedure code rule
    By debmorrison in forum Orthopaedics
    Replies: 0
    Last Post: 01-25-2010, 06:24 AM
  5. Crohn's
    By coderguy1939 in forum Gastroenterology
    Replies: 0
    Last Post: 05-12-2009, 08:56 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?


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.