# Help 0n Diagnnosis Code



## whatwillthen@hotmail.com (Jul 11, 2013)

A patient  is brought to the emergency department after the patient ingested a entire bottle of verapamil(estimated 20 pills) as a suicide attempt,as they left  a note. Physician used glucagon HCI as an antidote it consisted 10mg/100 ml of D5W in an IV over 2 minutes., followed by 5mg/1ooml of d5W per hour for 2 more hours. A gastric lavage and aspiration was done.  patient's vital signs stabilized the  lab work returned to normal over the next few hours.  Patient  was transferred to inpatient psychiatric facility for follow-up treatment on her suicide attempt. ICD-9, CPT, HCPCS Level 2 Codes.
Is the cpt code 43753 correct for gastric lavage?Is E950.4 correct for the e code. I am having trouble finding the diagnosis code.
Is 99285 and 99255 for the medicines. Is J1610 right on the medicines.


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## terribrown (Jul 12, 2013)

whatwillthen@hotmail.com said:


> A patient  is brought to the emergency department after the patient ingested a entire bottle of verapamil(estimated 20 pills) as a suicide attempt,as they left  a note. Physician used glucagon HCI as an antidote it consisted 10mg/100 ml of D5W in an IV over 2 minutes., followed by 5mg/1ooml of d5W per hour for 2 more hours. A gastric lavage and aspiration was done.  patient's vital signs stabilized the  lab work returned to normal over the next few hours.  Patient  was transferred to inpatient psychiatric facility for follow-up treatment on her suicide attempt. ICD-9, CPT, HCPCS Level 2 Codes.
> Is the cpt code 43753 correct for gastric lavage?Is E950.4 correct for the e code. I am having trouble finding the diagnosis code.
> Is 99285 and 99255 for the medicines. Is J1610 right on the medicines.



1.  43753 Gastric lavage code is correct
2.  E950.4 Suicide attempt code is correct
3.  DX code can be found in the Table of Drugs and Chemicals under "antihypertensive agents NEC" as verapamil or hydrochloride are not available in this table. The poisoning code given is 972.6.
4. 99285 is in the Emergency Dept Services subcategory of E/M and can only be assigned if documentation validates this level of service.
5. 99255 is for an inpatient consultation E/M and can only be assigned if documentation validates.  (I am confused why you gave these two options together? An E/R physician would not bill an inpatient consultation code and an inpatient consult would only result after admission to the hospital and therefore the physician cannot submit an emergency dept code. ????)
6.  J1610 is correct for glucagon HCI but keep in mind, the code description states per "1 mg" and over the course of treatment, 20 mg were administered. You would denote 20 units on your claim form.


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## mitchellde (Jul 12, 2013)

whatwillthen@hotmail.com said:


> A patient  is brought to the emergency department after the patient ingested a entire bottle of verapamil(estimated 20 pills) as a suicide attempt,as they left  a note. Physician used glucagon HCI as an antidote it consisted 10mg/100 ml of D5W in an IV over 2 minutes., followed by 5mg/1ooml of d5W per hour for 2 more hours. A gastric lavage and aspiration was done.  patient's vital signs stabilized the  lab work returned to normal over the next few hours.  Patient  was transferred to inpatient psychiatric facility for follow-up treatment on her suicide attempt. ICD-9, CPT, HCPCS Level 2 Codes.
> Is the cpt code 43753 correct for gastric lavage?Is E950.4 correct for the e code. I am having trouble finding the diagnosis code.
> Is 99285 and 99255 for the medicines. Is J1610 right on the medicines.



Go to the coding guidelines and look under poisoning for the correct way to code for poisoning there is a specific order in which codes must be listed when it is a poisoning, also use your table of drugs and chemicals.  If I were to give you the answers you would not have the fun of discovering them on your own   also the E&M codes you have do not make sense, for the same provider you cannot assign 2 E&M on the same day, so there is confusion as to what you are coding.  Without the actual encounter note it is next to impossible to advise you as to correct coding.  You also have not ptovided what her presenting condition/symptoms are, this must be known as it also must be coded.


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