Otolaryngology Coding Alert

Question: An allergy patient on prednisone presented with nervousness, a headache and high blood pressure. The otolaryngologist found that he had an adverse reaction to the medication. Should I code for poisoning or for an adverse reaction?

Illinois Subscriber

Answer: The diagnosis code depends on whether the patient took the prednisone correctly or incorrectly (that is, an overdose). If the patient took the medication according to the otolaryngologist's instructions but had an adverse reaction, you should code for the symptoms. Report 799.2 (Nervousness), 784.0 (Headache) and 796.2 (Elevated blood pressure reading without diagnosis of hypertension). Also include E932.0 (Drugs, medicinal and biological substances causing adverse effects in therapeutic use; hormones and synthetic substitutes; adrenal cortical steroids).

But if the patient took the prednisone in a way contrary to the prescription, use 962.0 (Poisoning by hormones and synthetic substitutes; adrenal cortical steroids) to indicate poisoning. Report the symptoms (799.2, 784.0 and 796.2) as secondary. Also, include an E code to show the external cause of the poisoning. If the patient took the wrong dose, for example, use E858.0 (Accidental poisoning by other drugs; hormones and synthetic substitutes).