Primary Care Coding Alert
Multiple Diagnoses Are Fine – if They Aren't Symptoms
Question: Can I code tonsillitis, pharyngitis, and upper respiratory infection together? Or is it all part of the upper respiratory infection?
Answer: Yes, you can include each of the three diagnoses on the claim. Appropriate choices might include 463 (Acute tonsillitis), 462 (Acute pharyngitis), and 465.x (Acute upper respiratory infections of multiple or unspecified sites).
Caution: ICD-9 guidelines state that you shouldn’t code symptoms and also the disease (such as pneumonia with cough or fever since these are likely symptoms of the pneumonia). In your case, the tonsillitis and pharyngitis could be part of the upper respiratory infection, but they are not automatically part of it. If your physician documents all three separately, then you should report all three diseases, and the insurance company should allow all three diagnoses.
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Primary Care Coding Alert
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