# sinusitis debate



## Cottrell (Nov 12, 2008)

I need some opinions please. We are having a debate about the right dx for "sinusitis". Some of us say 
473.9, since chronic is in parenthesis, or 
461.9 because the other code is under the 473 chronic heading.
We need some opinions and a reference or two would be great! Thanks all.


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## FTessaBartels (Nov 12, 2008)

*461.9*

If the doctor doesn't tell me it's chronic, I code it as acute because *I *only *know *about *this* episode.

Just my opinion.

F Tessa Bartels, CPC, CPC-E/M


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## dmaec (Nov 12, 2008)

I code sinusitis the opposite as Tessa -- I code it as 473.9 - UNLESS it's stated as acute - (or one of the other subheadings - allergic, frontal, maxillary, etc). I too believe because "chronic" is in parentheses - it's a supplementary word - nonessential.


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## mbort (Nov 12, 2008)

I code it both ways 

If it were an initial e/m I would use the acute.
If the patient has been seen multiple times for the same thing, I use chronic.
If the patient has surgery, I use chronic.


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## Cottrell (Nov 12, 2008)

*clarification*

Let's say for arguements sake, you have a piece of paper with the word
"Sinusitis" on it. What code do you use without any other information?


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## dmaec (Nov 12, 2008)

well, with that scenario - I'd be coding the 473.9


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## mbort (Nov 12, 2008)

I wouldn't code it without some sort of additional information.


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## Anna Weaver (Nov 12, 2008)

*sinusitis*

I code as 473.9 unless stated otherwise. 

Again, this looks like a coders choice!!!


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## FTessaBartels (Nov 13, 2008)

*Acute*

Let's say for arguements sake, you have a piece of paper with the word "Sinusitis" on it. What code do you use without any other information?

First, Mary is right ... you'd probably want to ask for more info ... 

If I didn't *KNOW *that the patient has been seen for this multiple times or has had surgery for this problem, I'd code it as acute - 461.9

F Tessa Bartels, CPC, CPC-E/M


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## esmith (Nov 24, 2008)

*Sinusitis*

“In the case of sinusitis, the term “Chronic” is a nonessential modifier after the main term, so that means that the term does not have to be in the diagnostic statement to use that code. So in the case of sinusitis when unspecified it should be coded as 473.9 (chronic).”


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## magnolia1 (Nov 24, 2008)

I use 473.9 to  code Sinusitus without any further info provided.


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## mstenochs (Nov 25, 2008)

473.9 also has my vote. Without further information stating Acute or Chronic it would be the unspecified. 
Although in my work setting we would request further clairification from the provider.


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