# N39.0 uti



## karenpez (Nov 22, 2016)

I have recently started receiving denials from our billing office regarding the use of N39.0 (UTI) without the additional B95-B97 code.  When I query the physicians they tell me they may never know the infectious agent because they do not test for it.  This just seems to be an issue that has just started.  Is anyone else receiving these denials and how are you coding these without the B95-B97?  My gut reaction is telling me signs and symptoms but the physicians have me questioning my gut!!  Please help!
thanks
Karen


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## mitchellde (Nov 22, 2016)

N39.0 is one of those nasty unspecified codes.  However it will be up to us to teach the insurance payers that this is an acceptable use of unspecified.  Providers are expected (allowed ?) to diagnosis infections based solely on an examination of the patient.  Because this is often the case there will be no way for the provider to know the offending organism.  Therefore you will need to appeal these with that type of logic.


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## kwatson0 (Nov 30, 2016)

karenpez said:


> I have recently started receiving denials from our billing office regarding the use of N39.0 (UTI) without the additional B95-B97 code.  When I query the physicians they tell me they may never know the infectious agent because they do not test for it.  This just seems to be an issue that has just started.  Is anyone else receiving these denials and how are you coding these without the B95-B97?  My gut reaction is telling me signs and symptoms but the physicians have me questioning my gut!!  Please help!
> thanks
> Karen



Which insurance companies are denying? our lead coder said you should bill symptoms per guidelines. Send patient for culture and use B code if applicable second appointment.


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## MacksMom (Aug 20, 2018)

mitchellde said:


> N39.0 is one of those nasty unspecified codes.  However it will be up to us to teach the insurance payers that this is an acceptable use of unspecified.  Providers are expected (allowed ?) to diagnosis infections based solely on an examination of the patient.  Because this is often the case there will be no way for the provider to know the offending organism.  Therefore you will need to appeal these with that type of logic.



The guidelines for the correct coding of a UTI are stated in the ICD10 book.  You can try to appeal to the AMA to change the ICD10 guidelines, but the guidelines were put into place for a reason.  The guidelines under diagnosis N39.0 state that we must use an additional code between B95-B97 to identify the infectious agent.  Being able to diagnose a patient with a UTI without a culture is becoming a thing of the past.  ICD10 is seeing to that.  Soon, our providers will be paid based on the diagnoses they use.  We want our providers to code to the highest specificity so that they receive maximum payment for the services they render.  If we continue to allow our providers to code incorrectly, use unspecified diagnosis codes, do the same thing they 've always done in the past, then we're doing a disservice to not only ourselves and our providers we are also doing a disservice to our patients.  I'm helping to educate our providers, and our providers appreciate it.


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