ED Coding and Reimbursement Alert

Question: A mother presents with her newborn baby and says she is concerned about the baby -choking,- or spitting up frequently after she has been fed. The physician performs a level-two evaluation and management service on the newborn. What diagnosis code should I use? I was thinking 933.1, but this code does not seem very accurate.

Oregon Subscriber

Answer: Choosing 933.1 (Foreign body in pharynx and larynx; larynx) should have given you pause because there is a diagnosis code that better represents this patient's condition.
 
On the claim,
 
- report 99282 (Emergency department visit for the evaluation and management of a patient, which requires these three key components: an expanded problem- focused history; an expanded problem-focused examination; and medical decision- making of low complexity) for the E/M service.
 
- attach ICD-9 code 779.3 (Feeding problems in newborn) to 99292 to represent the baby's spitting up.

 -- Reader Questions and You Be the Coder reviewed by Michael A. Granovsky, MD, CPC, FACEP, vice president of Medical Reimbursement Systems Inc., an ED coding and billing company in Stoneham, Mass.