Dont Panic When Coding for Meningitis Counseling
Published on Wed Aug 01, 2001
Chances are that few, if any, of your patients will contract meningococcal meningitis (036.0). But recent outbreaks of the fatal disease, which strikes mostly high school and college students, have sent parents into panic. Many parents in the country heard about the Ohio outbreak this past spring and were demanding more information. Pediatricians were deluged by telephone calls from frantic parents who wanted to know if they should keep their children home from school.
Parents want to know exactly what the disease is and how it is spread and if their children should be immunized. How can you handle these circumstances and recoup some reimbursement? And how should you handle general prevention of meningococcal meningitis?
One of the primary educational tasks of the pediatrician is to differentiate between meningococcal and viral meningitis (047.9, aseptic). Meningococcal is the disease that captured headlines and panicked parents. Viral meningitis is much more common and less serious. But because it is more common, your practice is likely to get many calls from parents who have read newspaper stories or seen the news on TV about meningococcal meningitis and heard about a child in their school who has viral meningitis. These parents register only the word "meningitis," so your staff will first need to ascertain what kind of meningitis the child was really exposed to.
Once you know the parent is referring to meningococcal meningitis, you can proceed with counseling and, if necessary, prophylaxis.
Meningococcal Meningitis in the Community
If a child in your community develops meningococcal meningitis, be assured that you and your staff will spend much time on the telephone discussing this with your patients' parents.
In such a situation, any child who has been exposed to the disease should be immunized. "This means children in the same family. It does not necessarily mean children who go to the same school should be vaccinated," says Louis Cooper, MD, FAAP, vice president of the American Academy of Pediatrics and professor of pediatrics at Columbia University in New York City.
Most children should not be vaccinated for meningococcal meningitis on a routine basis, because these vaccinations can limit immunity and are expensive, Cooper says.
Nevertheless, when they hear that a vaccine is available (CPT 90733 , meningococcal polysaccharide vaccine [any group(s)], for subcutaneous or jet injection use), these parents will almost invariably want it, whether it's necessary or not. You must explain to the parent why vaccination may not be necessary -- a possibly time-consuming process that you cannot be paid for unless you see the child.
Your nurse can explain the guidelines for exposure and immunization over the telephone. If the parent accepts the nurse's explanation and retreats from the request for the immunization, then the case ends [...]
