Otolaryngology Coding Alert

Your only two concerns should be manifestation and type of fungus. Though uncommon, some sinus infections are caused by fungus. When the otolaryngologist diagnoses a patient with fungal sinusitis, a single code will not be your easy way out. Instead, you should rely on a combination of ICD-9 codes, and a careful examination of the physician's notes for manifestations. Scenario: A patient reports to the office complaining of severe headaches, loss of appetite and postnasal discharge into the throat. An ENT diagnoses the patient with fungal sinusitis confirmed on culture. She also notes down that a chronic ethmoidal kind of sinusitis due to aspergillosis afflicts the patient. If you check the ICD-9 manual for a code for fungal sinusitis, you would be directed to 117.9 (Other and unspecified mycoses). But a single code may not appropriately describe the patient's condition. Here's what you should do: 1. List Manifestation As Primary [...]