Ob-Gyn Coding Alert

Reader Questions:

You'll Have Difficulty Reporting 296.99

Question: Which diagnosis code should I use for seasonal affective disorder (SAD)? I looked in the ICD-9 manual under "depression" and "disorder" but did not find anything under these headings.


Montana Subscriber


Answer: First, the best code for this disorder is probably 296.99 (Other specified episodic mood disorder), but notice how ICD-9 lists that diagnosis in the mental- health chapter.

For many payers, the use of this diagnosis means either 1) an ob-gyn is not qualified to treat mental illness, 2) the patient does not have mental-health benefits, 3) she has mental-health benefits with a different co-pay structure, or 4) you have labeled her as mentally ill.

Think about what exactly the ob-gyn is treating her for. If the ob-gyn truly treats her for affective disorder, then go with the code. However, if your documentation shows that the patient may also have PMS or even premenstrual dysphoric disorder (PMDD), look at 625.4 (Premenstrual tension syndromes).

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