# Multiple site insect bites



## TJAlexander (May 11, 2016)

Patient presents with bug bites on bilateral arms, legs, neck and back.  Would you code this visit using the 'S' code for each site or do you think I'm safe using L53.8 'Other specified erythematous conditions'.  If so, can we use the W57.XXXA code to specify with the use of an 'L' code?  I know 'W' codes are used to specify causality for injury but wasn't sure if they could be used in other situations.  I just was trying to prevent having to code with 8 diagnosis codes if possible.......


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## CodingKing (May 11, 2016)

L53.8 would not be appropriate as that is a symptom of a bug bite and you don't code to the symptoms when there is a definitive DX. You are going to have to code for the bites and sites. if I remember right from someone's post earlier this year, there is no general bug bites all over body DX. I don't think this qualifies as Sequela either.


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## kdlepek (May 11, 2016)

*No multiple bite code*

You have to code for each of the bites and sites. There isn't a code for multiple and L53.8 is a symptom. You can't code for symptoms when a definitive DX is available. Hope this helps.


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## TJAlexander (May 11, 2016)

*Thanks!*

That does help.  Thank you!


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## Fahad.Ogagang@MiraMedGS.com (May 11, 2016)

*this is what I learned about this*

Coding for Multiple Insect Bites All Over The Body, S code does not provide appropriate code for insect bites that involved multiple sites, coding each body part might not be applicable and the best way to code this is T07 plus the code W57.XXXA.


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## mitchellde (May 11, 2016)

I would not use T07 as the documentation does appear to have specified that this was insect bites.  Therefore it is not correct to use unspecified multiple injuries.  in addition it appears that the original post does state that all areas involved were indicated, it was just 8 different areas.  You have the ability to append 12 dx codes for each claim submission so it s no problem to code for each individual area.


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## Fahad.Ogagang@MiraMedGS.com (May 11, 2016)

well I just got that answer from a previous post in this forum, according to her she got her answer from Washington Medical Association and they said that coders can use T07 for this case. 
I think that T07 plus the L codes for the manifestations and the W code for specificity could also be the appropriate code for this...


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## mitchellde (May 11, 2016)

Fahad.Ogagang@MiraMedGS.com said:


> well I just got that answer from a previous post in this forum, according to her she got her answer from Washington Medical Association and they said that coders can use T07 for this case.
> I think that T07 plus the L codes for the manifestations and the W code for specificity could also be the appropriate code for this...



I just do not feel it is appropriate to use an unspecified injury code when the injury and locations are specified in the documentation.  It goes against everything we have been taugh to do.  In addition the guidelines state:
When coding injuries, assign separate codes for each injury unless a combination code is provided, in which case the combination code is assigned. Code T07, Unspecified multiple injuries should not be assigned in the inpatient setting unless information for a more specific code is not available.
I would never advise using the T07 code hen the documentation is specific.


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## CodingKing (May 12, 2016)

mitchellde said:


> I just do not feel it is appropriate to use an unspecified injury code when the injury and locations are specified in the documentation.  It goes against everything we have been taugh to do.  In addition the guidelines state:
> 
> When coding injuries, assign separate codes for each injury unless a combination code is provided, in which case the combination code is assigned. Code T07, Unspecified multiple injuries should not be assigned in the inpatient setting unless information for a more specific code is not available.
> I would never advise using the T07 code hen the documentation is specific.



Some people are going to be in for a rude awakening in a few months when payers start denying many unspecified codes.


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## mitchellde (May 12, 2016)

Yes I agree, especially if the documentation can be and is more specific.


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