Pediatric Coding Alert

Question: For an electrocardiogram (ECG) (93000-93010, Electrocardiogram, routine ECG with at least 12 leads ...) done to monitor medication (stimulant, antipsychotic), should I use late effect of medication code 909.5? Ohio Subscriber Answer: No, you should instead use V58.69 (Long-term [current] use of other medications), which is for monitoring of other high-risk medications, such as Ritalin, as the secondary diagnosis. The ICD-9-CM Coding Guidelines V code table lists V58.69 as an additional code only. For the primary diagnosis, use the reason why the patient is on the medication -- for instance, attention deficit disorder of childhood with hyperactivity (314.01). A late effect is the conditions produced after the acute phase of an illness or injury has terminated, according to 2009 ICD-9-CM Coding Guidelines, Section 1, B, 12. Example: An adolescent boy presented with light-headedness (780.4, Dizziness and giddiness), and blurred vision (368.8, Other specified visual disturbances) after taking a prescribed dose [...]