Primary Care Coding Alert

College-town FPs: V01.84 explains meningitis-outbreak evaluations

Do you wonder which diagnosis to submit when an asymptomatic child presents due to chickenpox exposure? ICD-9 answers this and two other "contact with" coding questions.
 
When new ICD-9 codes become effective Oct. 1, insurers will reject V01.7 and V01.8 claims. These codes, as well as 796.6, now contain more specific diagnoses.
 
To claim reimbursement when you first submit disease-exposure and PKU encounters, choose your code based on these methods:

Use V01.71 for Chicken Pox Exposure

You can specifically identify contact with or exposure to varicella thanks to ICD-9's introduction of V01.71 (Contact with or exposure to communicable diseases; other viral diseases; varicella). "If a mother brings her 6-year-old son in because he was playing with a child who came down with chicken pox, you should use V01.71," says Jeffrey Linzer Sr., MD, MICP, FAAP, American Academy of Pediatrics representative to the ICD-9-CM editorial advisory board. The V code indicates that the parent brought the child in for varicella exposure, and the physician's examination shows that the child has no signs or symptoms of the disease.
 
Old way: You previously would have lumped varicella exposure under V01.7 (... other viral diseases). Don't report this code after Oct. 1. Payers will reject the code as lacking a fifth-digit subclassification.

Identify Meningitis-Scare Exams With V01.84

You should also add V01.84 (... other communicable diseases; meningococcus) to your encounter sheet. "It will be great to have the 'contact with' meningitis code," says Daniel S. Fick, MD, director of risk management and compliance for the College of Medicine faculty practice at the University of Iowa in Iowa City.
 
Why: In college towns when the health department reports one meningitis case, the whole student body runs to the doctor, Fick says. These FPs can now specifically identify why they are examining asymptomatic patients.
 
Best way: You should submit meningitis contact or exposure as V01.84. Prior to ICD-9 adding this code, you would have to code the encounter with an other-specified code (V01.89, ... other communicable diseases).

Report Swimming-Pool E. Coli Contact as V01.83

Another new V code that will come in handy is V01.83 (... escherichia coli [E. coli]). "You'll mainly use this code when a physician evaluates a patient for E. coli exposure due to an outbreak at a local pool that the child frequents," Linzer says.
 
Old method: You previously should have coded E. coli exposure as another communicable disease (V01.89). ICD-9 2004 contained no specific code for contact with or exposure to E. coli.

Designate Abnormal Neonatal Screen With 796.6

Say good-bye to other specified codes for positive phenylketonuria (PKU) results. ICD-9 2005 introduces a code for abnormal lab findings: 796.6 (Other nonspecific abnormal findings; abnormal findings on neonatal screening).
 
Benefit: Now you can specifically identify abnormal neonatal screening findings with 796.6. For instance, an FP counsels a nonsymptomatic neonate's parents on the repercussions of an abnormal PKU test. You should assign 796.6 for the abnormal lab results.
 
Because no code previously existed for a positive PKU test, you would have had to use 796.9 (... other).