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Diagnosis for chronic colitis with ulcer fragments

  1. #1
    Default Diagnosis for chronic colitis with ulcer fragments
    Medical Coding Books
    If you were coding a colonoscopy and got a path that read -
    Active chronic colitis,moderate-severe,with prominent ulcer bed fragments.
    Negative for dysplasia or malignancy.

    What diagnosis would be appropriate? I was thinking since ulcer fragments was found an ulcer had to present, would ulcerative colitis 556.9 be appropriate or would you just code the chronic colitis, 558.9? Differences of opinions in our office.

  2. Default
    I personally would code active chronic colitis-- because the path report is clear about that.
    If the path report said chronic ulcerative colitis then i would bill with that, but it doesn't appear to come right out and say that.

    Hope it helps,

    Caprice, CPC

  3. Smile
    Hello if it was me I would code use the chronic colitis code 558.9. I'm a recent student who just finished medical billing and coding will be taking my coding exam next month
    Last edited by; 05-14-2010 at 07:20 AM.

  4. #4
    Temple, TX
    I've coded and billed GI for almost 3 years and I would bill 558.9 as my primary diagnosis as the path report does not specifically state that the colitis is ulcerative.

  5. Default
    I work for a group of pathologist, and I would code this as active colitis 558.9 based on the path report alone.

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