Pediatric Coding Alert

Reader Question:

'Bullying' Codes Take Back Seat to Main Symptoms

Question: Which diagnosis code should we report when bullying is a factor? We had a 13-year old who presented with a concussion after being beaten at school by another student. I know we can use concussion or the other symptoms he presented with (headache, dizziness, fatigue, etc...) but the doctor wanted to list a code for the bullying. She originally used 995.81 (abused person, NOS) which is incorrect because that's for an adult. Can you advise?Rhode Island SubscriberAnswer: You are correct that the concussion or other symptoms should be listed first. If you want to add an ICD-9 code for confirmed abuse, you should consider 995.51 (Child emotional/psychological abuse), 995.54 (Child physical abuse), or 995.59 (Other child abuse and neglect). You should also consider an "E" code to designate who perpetrated the abuse. For instance E967.4 (Perpetrator of child and adult abuse by child).
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