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ICD-9 reporting for potential child abuse

  1. Unhappy ICD-9 reporting for potential child abuse
    Medical Coding Books
    My Dr saw an infant in the hsp diagnosed with multiple fractures at various degrees of healing. Case has been presented to Bureau of Child Welfare for "potential child abuse".
    I remember reading somewhere this needs to be reported to the insurance companies on the claims. But since this was "potential" abuse, how do I code this? Should I use 995.54 Child Physical Abuse, or do the same rules apply as in not reporting suspected conditions?
    Thanks so much!

  2. #2
    North Carolina
    Take a look at V71.81-As far as the fractures, it's somewhat hard to say without reading the documentation but I would probably look at a fx code also since you stated the fx's were healing at different degrees. Maybe an aftercare fx code?

    (Read page 6)
    Last edited by RebeccaWoodward*; 10-08-2008 at 10:51 AM.
    Rebecca CPC, CPMA, CEMC

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  3. #3
    Milwaukee WI
    Default V71.81
    I like V71.81 rather than giving a definitive diagnosis.
    Remember that this record follows the patient FOREVER. You don't want to give them a condition they do not have. (There are congenital conditions that could cause multiple fractures without any abuse.)

    F Tessa Bartels, CPC, CPC-E/M

  4. #4
    Bradenton, Fl
    There are also "E" codes for this:

    Abuse (alleged) (suspected) E967.X

    You could possibly put the "E" code with the fx code??
    Angie Olson, CPC

  5. Default
    Thanks to all for the responses... V71.81 was just what I was looking for! Have a great day!

  6. Default
    would the v71.81 code be appropiate if the exam is for possible abuse?

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