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Thread: Abdominal pain concept - Dx code

  1. #1

    Default Abdominal pain concept - Dx code

    AAPC: Back to School
    I have a clarifications when the clinical indication is RLQ abdominal pain and LLQ abdominal pain do we need to code as 789.01 and 789.04 or 789.09 alone? Also attach any coding source document supporting for this?

    Thanks in advance!
    Sivaraj Ramesh CPC
    Sivaraj BPT CPC

  2. #2

    Default RE: "other" and unspecified codes.

    Conventions for the ICD -9 CM
    See-Section 1 A 5. other and unspecified codes.

    Other and Unspecified codes

    a.“Other” codes
    Codes titled “other” or “other specified” are for use when the information in the medical record provides detail for which a specific code does not exist. Index entries with NEC in the line designate “other” codes in the Tabular. These Index entries represent specific disease entities for which no specific code exists so the term is included within an “other” code.

    b. “Unspecified” codes
    Codes (usually a code with a 4th digit 9 or 5th digit 0 for diagnosis codes) titled “unspecified” are for use when the information in the medical record is insufficient to assign a more specific code.

    You'll find the codes highlighted in VOL 1(Unspecified & other specified.) 789.00 & 789.09

    So if record provides specifc anatomic documentation, we'll assign 789.01 & 789.04 NOT 789.09.

    Last edited by msrd_081002; 12-22-2010 at 06:11 AM.

  3. #3

    Cool Sathish B.P.T,CPC

    In ICD book the code pretty clearly states as multiple sites in the tabular list.

    Moreover abdominal pain is only the symptoms, and the pain cannot be limited to specific quadrant, it can be radiate to one or more quadrants.

    Hence the document clearly states LLQ and RLQ pain, still we have to code 789.09 as the multiple site and not as separate codes 789.04 and 789.03

    Can anyone provide me the document that varies from ICD guideline.


    Sathish B.P.T,CPC

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