# Pre-travel motion sickness diagnosis



## arrana (Jan 2, 2013)

Hi,

We have a patient who came in because he was going to be travelling and is prone to motion sickness. He wanted a patch prescription. The provider coded the visit with 994.6 for motion sickness. Is that correct, since the patient isn't yet sick, only in anticipation of getting sick? I wasn't able to find anything else.

Thanks,
Arrana


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## mitchellde (Jan 2, 2013)

No that is incorrect as the patient is not at this time ill.  You will need a V code for this encounter, either issing of prescription or a prophylactic code.


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## arrana (Jan 2, 2013)

I used the same logic as the 994.6 didn't seem right to me, but our certified coder said he uses the it all the time on pre-travel encounters. It looks like since this is the patient's first prescription for the patch I should go with the V07.8 Other specified prophylactic measure. I looked at the V68.1 but that is for repeat prescriptions.

Thanks for your help!


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## mitchellde (Jan 2, 2013)

a lot of coders think for some reason that they must do this kind of coding to avoid the use of a V code.  However it is incorrect.  You need to remind these persons that the dx code is the patient's not yours, and if the patient does not possess that dx at the time of the encounter then the code cannot be assigned.  I agree with the V07.8 code


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## arrana (Jan 31, 2013)

Thanks Debra. Nice to have a voice of reason.


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## arrana (Oct 8, 2013)

Fast forward 9 months from the original post....

I had another provider use the motion sickness code for a pre-travel visit. She made the point that for this patient, motion sickness is a chronic condition, therefore she felt justified in using the 994.6. She equated it to a patient who has chronic migraines but not an active one during the visit, but she still codes migraine if that is what the visit is addressing. 

I'm still of the mindset that the 994.6 not be used in advance, even if chronic, but I would love some input from other coders on this. 

Thanks.


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## mitchellde (Oct 8, 2013)

no you would never code in this fashion:
COde 346.7 Chronic migrane-- Definition - A form marked by headache occuring 15 or more days per month for more than three months and is not the result of medication overuse.
994.6 Motion sickness - is in the chapter for injury and poisoning to indicate an effect of an external cause.  If there is no current problem with the patient then they cannot have a current injury or effect.  To prescribe treatment in advance of a problem is prophylactic treatment.  ( ICD-10 CM requires the external cause be coded as well.)
You cannot confuse a current injury code with codes that are designated as chronic such as the migrane.  
There is no code for chronic motion sickness, therefore the cooperating parties that have created this codeset do not intend this code to be used in that fashion.


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## arrana (Oct 8, 2013)

Thanks again, Debra! I'm going to copy your response directly to the provider. I really wish coding training was required for doctors!!


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## areeder (Oct 4, 2016)

*ICD-10 travel sickness code*

I am curious to know what code others would use for the prophylactics of motion sickness using the ICD-10 codes. We have a pt who came in and it worried about an upcoming flight so we gave a rx to help her but at the time of the appt she was not experiencing any sx. 
Pls help! 
Thank you!


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## crazybear4185@yahoo.com (Jun 16, 2017)

areeder said:


> I am curious to know what code others would use for the prophylactics of motion sickness using the ICD-10 codes. We have a pt who came in and it worried about an upcoming flight so we gave a rx to help her but at the time of the appt she was not experiencing any sx.
> Pls help!
> Thank you!





I used Z71.89. If you find anything better I would like to know!


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## ccr888 (Jan 31, 2019)

*"Prophylactic" for Motion Sickness*



crazybear4185@yahoo.com said:


> I used Z71.89. If you find anything better I would like to know!



Hello, I went down the research rabbit-hole on this today and was misled a few times before discovering that searching for "Prophylactic" in the ICD-10 Index leads to "medication Z79.899." I was surprised!

I came to this conclusion when looking at the ICD-10 Index for a code for seasickness prophylactic for someone with a history of seasickness about to go on a cruise. My interpretation is that because the Index says "Prophylactic/medication Z79.899" (and the Chapter listing gives no reason not to), it would be appropriate to use. My logic is that if someone has a condition such as susceptibility to motion sickness, it would qualify just as it would under your scenario...or for someone who carries nitroglycerin for use when needed.

I also used "Counseling/specified reason NEC Z71.89" which seems to fit for this situation because the doctor was trouble-shooting with the patient on how to handle this, and another intermittent, condition.

Cheers,
C. Roskam
Newbie Coder


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