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12 year old exposed to Sharps container

  1. Default 12 year old exposed to Sharps container
    Medical Coding Books
    We are a Pediatric office. We have a child who was exposed in another Dr office to a Sharps container. Apparently, he was able to remove some needles from the container and took them home. He did not have a needle stick that we are aware of. Mom and Dad brought him in to have HIV and HEP testing done. We used ICD V15.85 as the primary dx. Medicaid is denying the service as not medically necessary. We also billed a 99213. Any suggestions on what could have been billed differently?

  2. #2
    Milwaukee WI
    Default Some possiblities
    Who can tell WHY Medicaid denies things ... sometimes I think it's just to make us crazy.

    Did you also use the E-code for needle stick?

    Did Medicaid deny BOTH the E/M and the lab test?

    F Tessa Bartels, CPC, CEMC

  3. Default
    Thank you Tessa for your response.
    He didn't actually get stuck that we are aware of. His parents were rightfully concerned when they found him with the needles, but he wouldn't admit to getting stuck.

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