Practice Management Alert

Answer: Like ICD-9, the NEC (Not Elsewhere Classifiable) abbreviation contains codes for “other” types of specified conditions that haven’t already been classified. For example, you would use an NEC code if the physician specifies a complication arising with a colostomy but does not specify the manifestation. It would be K94.00 (Colostomy complication, unspecified).

 

When your physician doesn’t clearly specify the condition, you can use a NOS (Not Otherwise Specified) code — although payers usually frown upon this process. For example, suppose the gastroenterologist diagnoses ulcerative colitis but does not record a specific location. Even when you ask for additional detail, your gastroenterologist may not be able to provide you with an exact location. Without more information from your physician, you should report 556.9 (Ulcerative colitis, unspecified)