Gastroenterology Coding Alert

Question: Which diagnosis code should we use for a patient who feels as if there is a lump in her throat when she swallows? Our gastroenterologist gave us the diagnosis of "globus sensation."

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Answer: You should double-check with your gastroenterologist, but it sounds as if the patient has dysphagia (787.2). The only diagnosis code for globus is globus hystericus (300.11, conversion disorder).
 
There are two problems with using the globus hystericus diagnosis code, says Linda Parks, MA, CPC, lead coder at Atlanta Gastroenterology Associates, a 23- physician practice . The first is that it is a mental-disorder diagnosis, and a gastroenterologist is unlikely to be reimbursed for that type of diagnosis. Also for insurance purposes, you should be very careful before you label a patient with a mental-disorder diagnosis. That diagnosis stays with the patient for years and could cause her to be rejected for insurance coverage in the future.