Results 1 to 7 of 7

KOH, whiff test and wet mount

  1. Default KOH, whiff test and wet mount
    Medical Coding Books
    When a provider performs only a wet mount and a whiff test would I code 87210 x2 with a modifier 59?

  2. #2
    Default
    Hi JC,

    I see noone is daring to answer your question..

    In my opinion, you would only code for one unit, not two.
    I've seen providers do this. For the whiff test and then the confirmation under the microscope to verify the olfactory senses were right.

    See, if anyone else wil reply : )
    Hope this helps explain it.

    Barbara
    The Oracle

  3. #3
    Location
    Greeley, Colorado
    Posts
    2,045
    Default
    If you are preparing two slides why not code 87210, 87210-59?
    Lisa Bledsoe, CPC, CPMA

  4. Default
    Wet Mount: a sample of the specimen mixed with a salt solution(or KOH) on a microscopic slide and check for bacteria, WBC and unusual cell called clue cells.If CLUE cells are present- it is BV. A sort of a HANGING DROP preparation( for the shape and motiltiy, type)

    Wiffs Test:Saline/KOH is added to a sample to see a strong fishy odor is produced-meaning BV.
    These two tests with PH >4.5 enough to confirm the diagnosis.

    If want to be more grossly specific about the bacteria (Gram + or Gram –), take another slide Smear for Grams Stain ( a dry test method).eg, type of bacteria, fungi or Gardenella can be tentatively clued by this. This is a sort of a gold standard test.

    So as Curtis said you have to report 2codes if two preprations taken 1)Wet mount 2) Smear for Grams Stain.
    Wet mount report 87210. Grams stain Smear: 87205.

    The diagnosis Code:616.10/ .1x , if the doctor documented it.

    IF WET MOUNT AND WIFF TEST ARE THE ONLY DOCUMENTED PROCEDURES :

    My suggestions are:
    So far there is no code for Wiffs test directly but I could find odor Test which correlates well with: the amine odor of the vaginal fluid qualitative -82120 – Vaginal fluid , Amines qualitative for reporting wiffs Test And 87210 for wet mount.
    Both these tests are done at the office visit by the treating Physician because these are basic tests for which they are already trained very well.
    Did your Physician perform PH value test? Then it also adds up to the diagnosis.
    Hope it would help.
    Last edited by preserene; 08-26-2010 at 01:43 AM.

  5. #5
    Default
    Ok, I've confirmed with one of our providers.

    The whiff test, also called Amine 82120, is done when smelling the test after adding KOH to the slide.
    The slide is covered and send to the lab to check for clue cells and so on.

    Nevertheless, I would not feel comfortable for testing for both 82120 and 87220, because, the microscopic testing will just confirm what the provider has already confirmed through the whiff, including finding possible additional cells.

    I would think the insurance of the civilian world would deny the whiff and specific insurance carriers would probably bundle this or consider it fraud.
    The Oracle

  6. #6
    Thumbs up
    Ok, I've confirmed with one of our providers.

    The whiff test, also called Amine 82120, is done when smelling the test after adding KOH to the slide.
    The slide is covered and send to the lab to check for clue cells and so on.

    Nevertheless, I would not feel comfortable for coding for both 82120 and 87220, because, the microscopic testing will just confirm what the provider has already confirmed through the whiff, including finding possible additional cells.

    I would think the insurance of the civilian world would deny the whiff and specific insurance carriers would probably bundle this or consider it fraud.

    Have a great day.
    The Oracle

  7. Default
    Thank you Barbara. Yes as your doctor decides, it is our final too.
    So these 2 codes would suffice I think: 82120 and 87210 ( giving merits for the traditional and prevalently well accepted tests at the Physicians office settings).
    87220 I never mentioned. It is for skin hair and nail
    Just a brief note about Diagnosis of Vaginitis, to refresh our knowledge.
    Vaginitis:
    The most common causes of vaginitis are trichomoniasis (Trichomonas vaginalis infection), vaginal candidiasis (Candida vaginalis ), and bacterial vaginosis (BV).
    . The term vaginosis implies that infection is accompanied by little or no inflammation of the vagina; with overgrowth of anaerobic bacteria leading to replacement of lactobacilli and an increase in vaginal pH from less than 4.5 up to 7.0. Ideally, a diagnosis of BV is made if 3 out of 4 of 'Amsel's criteria' are met.
    Thin, white, homogenous discharge
    Clue cells (vaginal epithelial cells heavily coated with bacilli) on microscopy
    Vaginal pH greater than 4.5)
    presence of an amine odor after the addition of potassium hydroxide (also known as the "whiff" test).
    Testing for amines and pH testing is a well-established practice traditionally, Several aspects of the diagnosis are subjective - e.g., the visual examination of the discharge, reading the pH paper, and evaluation of the odor as part of the whiff test. A strong fishy odor on adding alkali to vaginal fluid (positive Whiffs Test).
    Microscopic examination may also reveal motile trichomonads or candida hyphae.
    Usually these tests are enough for diagnosis at the Physicians office settings, unless Grams score and BV Blue test like stuff are needed at the physicians discretion, mostly at the hospital settings.
    Thank you
    Last edited by preserene; 08-26-2010 at 10:17 PM.

Similar Threads

  1. wet mount thrush
    By smaher82 in forum Pathology & Clinical Laboratory
    Replies: 0
    Last Post: 03-20-2015, 02:45 PM
  2. Wet Mount/KOH
    By dpetersen in forum OB/GYN
    Replies: 3
    Last Post: 02-16-2015, 09:39 AM
  3. Toe nail trimming/koh/wet mount
    By cnramsey in forum Medicare Regulations
    Replies: 2
    Last Post: 09-04-2010, 12:56 PM
  4. Wet mount taken, different dx??
    By nscoder in forum Diagnosis Coding
    Replies: 0
    Last Post: 08-18-2010, 11:43 AM
  5. Wet mount 87210
    By heatherwinters in forum Family Practice
    Replies: 1
    Last Post: 03-11-2010, 11:02 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.