Pediatric Coding Alert

Question: In the July 2004 issue of Pediatric Coding Alert, you gave an example of a mother coming back for the TB test check. Which ICD-9 code should we link to CPT 99211 in this situation? New Jersey Subscriber Answer: When a patient returns for a follow-up visit to a TB injection, you should report ICD-9 code V74.1 (Special screening examination for bacterial and spirochetal diseases; pulmonary tuberculosis) and link it to 99211. If the test is positive, link it to 795.5 (Nonspecific reaction to tuberculin skin test without active tuberculosis). Additional evaluation by the physician could lead to an actual diagnosis of tuberculosis (010-018).

In our July 2004 article "4 Examples Show You When to Charge NPPE/Ms at 100 Percent," we offered an example that said, "A pediatrician orders a mother to return with her child for follow-up on his tuberculosis test. An MA checks the immunization site and records her observation." So if you reported 86580 (Skin test; tuberculosis, intradermal) and linked it to V74.1 for the initial visit, you should report 99211 (Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician. Usually the presenting problem[s] are minimal. Typically, 5 minutes are spent performing or supervising these services) and link it to V74.1 for the follow-up visit.