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In need of QA

  1. #1
    Greater Atlanta Professional Coders
    Default In need of QA
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    A 36 year old woman with a history of asthma for 10 years came in with increased shortness of breath and coughing. She is three months pregnant. A thorough exam was done including fetal monitoring. She was treated with inhalers and was discharged. Final diagnosis: acute exacerbation of COPD.

    I coded 59022-TC

    786.05, 493.22, V22.2

    Do I need to code for the asthma inhaler?

  2. #2
    Columbia, MO
    Unless the documentation supports that the current condition is not affecting the management of the pregnancy, you should not use V22.2. You should use a 648.93 first listed and then your acute exacerbation of the COPD. Look in the coding guidelines. The use of the V22.2 must be documented by the physician, :
    Chapter 11 codes have sequencing priority over codes from other chapters. Additional codes from other chapters may be used in conjunction with chapter 11 codes to further specify conditions. Should the provider document that the pregnancy is incidental to the encounter, then code V22.2 should be used in place of any chapter 11 codes. It is the provider’s responsibility to state that the condition being treated is not affecting the pregnancy.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Greater Atlanta Professional Coders
    Ok I got that point, but do I code for the inhaler treatment?

  4. #4
    use the exacerbation of COPD code.

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