# Coding Question (Help)



## dcourtney (Sep 27, 2008)

Hi;
I have a coding question on how to code for CADASIL (Cerebral Autosomal Dominant Arteriopathy with Sub-Cortical infarcts and Leukoencephalopathy). Also known as CASIL. My co-workers and I are in debate on how to code for this disease. Can anyone out there help me locate a more specific Dx code. Until just recently I'd never heard of this before.
Thanks
A desperate Coder


----------



## 007CPC (Sep 27, 2008)

I can't wait until the ICD-10 comes out.


----------



## junebug1969 (Sep 29, 2008)

According to: http://health-information.advanceweb.com/Article/Ask-the-Experts-March-24-2008.aspx
you would code this using 758.5 along with any additional codes to describe the manifestations and present complications of this disorder in the patient. According to the answer given, the official coding guidelines require that additional codes to describe the manifestations of a congenital anomaly when there is no specific code for the anomaly.


----------



## jmfarrer (Apr 13, 2022)

Have a question for coding a E&M visit for my specialty doctor for a patient in hospital.


----------



## csperoni (Apr 14, 2022)

jmfarrer said:


> Have a question for coding a E&M visit for my specialty doctor for a patient in hospital.


You didn't post what your coding question is, but from the attached denial, I'm making a guess that you don't understand why it's denied.  After seeing that it was billed 99253, my first instinct would be that the carrier does not accept consult codes, and you would code either 99221-99223 or 99231-99233 depending on the carrier guidance.
I would generally advise if you have a question to post it in a new thread, rather than an unrelated thread from 14 years ago.


----------



## crbosely (Dec 1, 2022)

hi, I have a coding question related to family practice office for diagnosis codes.  My question is can you code diagnosis codes that are suspected, associated with or consistent with.  I coded pelvic pain for this patient, in the documentation it said "consistent with PID.  Needless to say the correct diagnosis according to Practicode was PID and not the pelvic pain.  I am studying for an exam for family practice and really need to know if It is correct in using consistent with or suspected for this specialty.  This question was using 2021 guidelines.  thank  you, Carolyn


----------



## sls314 (Dec 1, 2022)

crbosely said:


> hi, I have a coding question related to family practice office for diagnosis codes.  My question is can you code diagnosis codes that are suspected, associated with or consistent with.  I coded pelvic pain for this patient, in the documentation it said "consistent with PID.  Needless to say the correct diagnosis according to Practicode was PID and not the pelvic pain.  I am studying for an exam for family practice and really need to know if It is correct in using consistent with or suspected for this specialty.  This question was using 2021 guidelines.  thank  you, Carolyn



Was it an inpatient note by chance? 

Inpatient guidelines allow capturing of suspected diagnoses. Outpatient does not.


----------



## TThivierge (Dec 3, 2022)

Hello Crbosely,  
You must be careful of integral coding and Excludes Rule1 coding related to assigning dx codes. This is overcoding due to some disease have signs & symptoms (describe illness in notes) to let provider be aware of a certain illness. The PID dx code above would not involve coding pelvic pain dx R10 too.  Integral coding is coding the final definitive dx not all the signs and symptoms (describes current illness)too on the same claim. In _outpatient _coding not allowed, but it can be allowed in inpatient coding. See IDC10 manual rules section G23 Chap 18 number b and  pg G5 section General Coding Guidelines. Also you will assign dx codes from the assessment the provider has given you which is your best bet.

But here are examples of *Integral Coding i*n OP setting are  ...
Dx J44 COPD then add on claim R05 Cough or R06 Wheezing or Shortness of Breath R06.02
Dx Hemorrhages K64 then add K62.89 Rectal Pain on claim
Dx K21.9 GERD then add dx R12 Heartburn and R14.1 Gas Pain on same claim
It is like if patient has pain from laceration of right lower leg limb dx S86.121 do not add the code the pain of lower right leg dx M79.604
Well I hope this explanation helps you understand Integral coding.

E_xcludes Rules 1 _is usually dx have similar meanings so not want to put on same claims, whereas can use Excludes Rules 2 on certain dx codes..Look at D50 and K74 have Excludes Rules 1 dx codes cannot use same time on same claim. Similar meanings.
Have a good day .Did I help you? I hope so 
Lady T


----------



## lgardner (Dec 5, 2022)

TThivierge said:


> E_xcludes Rules 1 _is usually dx have similar meanings so not want to put on same claims, whereas can use Excludes Rules 2 on certain dx codes..Look at D50 and K74 have Excludes Rules 1 dx codes cannot use same time on same claim. Similar meanings.
> Have a good day .Did I help you? I hope so
> Lady T


just a clarification. 

EXCLUDES 1 - CAN be submitted at the same time, IF the documentation clearly states that they are not related.

here is part of the ICD guidelines (I.A.12.b) on EXCLUDES 1: "An exception to the Excludes1 definition is the circumstance when the two conditions are unrelated to each other. If it is not clear whether the two conditions involving an Excludes1 note are related or not, query the provider."


----------

