Pediatric Coding Alert

Question: A pediatrician I code for writes "gross motor delay." Unfortunately, her office doesn't send me any notes or other information. Previous coders have been using 783.42 and 315.9, which I feel are not specific enough to the diagnosis. Should I continue to use 783.42?

Ohio Subscriber

Answer: Code 783.40 (Lack of normal physiological development, unspecified) is more appropriate for "gross motor delay," which is a developmental delay. This notation should be sufficient documentation to use 783.40. Other terms that fall under 783.40 include "inadequate development" and "lack of development."

Here's the inside scoop on the codes you mention:

• Code 783.42 (Delayed milestones) is more for a missed milestone, such as a late talker or walker, which is different than an overall developmental delay.

• Category 315 (Specific delays in development), which includes 315.9 (Unspecified delay in development) refers more to central nervous system (CNS) delays, such as speech (315.39, Developmental speech or language disorder; other) and ataxia (315.31, Expressive language disorder) than physiologic delays.

Tip: Make categorizing "gross motor delay" easier with these vocab words:

* A physiologic delay refers to abnormal internal functioning of the body.

* Gross motor physiologic delay means abnormal movement of a person's large body muscles including legs, arms, and abdomen, which inhibit normal walking, jumping and running.