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Thread: Is There A Dx Code For Sx That Fail And Have To Be Repeated?

  1. #1

    Default Is There A Dx Code For Sx That Fail And Have To Be Repeated?

    AAPC: Back to School
    ; I have a provider that performs cpt px 92585, comprehensive ABR's frequently on young children. Often the child won't cooperate or is "squirmy" and the test fails. The audiologist performs the whole test, does all the work involved, and yet because the test fails she has to perform it again. Is there a diagnostic code for the failed test so that when she bills the next attempted test she will get payed?

    Thank you, Tamera Wilcox

  2. #2


    This is a rough one, what about 999.9: OTHER AND UNSPECIFIED COMPLICATIONS OF MEDICAL CARE, NOT
    ELSEWHERE CLASSIFIED; Complications, not elsewhere

  3. #3
    Join Date
    Apr 2007
    Louisville, KY


    I would be hesitant about using a "complication" code in this instance. Just because an exam or test yields no results is hardly grounds for assigning a complication--which would indicate that the procedure, test, etc has [I]resulted in[I]or caused a complication.

    A child being unwilling or combative is not a complication of care. I'd be reluctant to assign anything from that category. However, if the exam cannot be completed (regardless of whether it is successful), I'd assign something from V64 category, perhaps (if documented) a V40.3.

    The success or failure of a service is irrespective to whether that service codable or billable. Of course, payable is another issue.

    Hope this helps some.

    Good luck.
    Kevin B. Shields, RHIT, CPCO, CCS, CPC, COC, CCS-P, CPC-P, CPC-I

  4. #4
    Join Date
    Apr 2007


    I'm not familiar with audiology but what about a modifier for discontinued services or reduced services??

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