Pediatric Coding Alert

Question: Can you suggest a suitable code to use for a fussy, irritable child with no specific ailment? We have been using 799.2 (nervousness) but we are not getting paid.

Nevada Subscriber

Answer: Diagnosis code 799.2 is not likely to be paid because it is too vague and not appropriate for pediatrics. Two codes that are more suitable are 520.7 (teething syndrome) and 079.99 (unspecified viral infection). Many pediatricians prefer 520.7, but sometimes you need to tell the insurer that this is not a dental problem that would be excluded for lack of dental coverage.