Primary Care Coding Alert
Code Differently for 'Alterations' and 'Blackouts'
Question: A 25-year-old new patient reports to the FP for his initial visit. He says that for the past three weeks, he has "zoned out" for no reason several times, but did not lose consciousness during any of the episodes. The FP provides a level-two E/M and diagnoses "episodic abnormality of consciousness; etiology uncertain." Which ICD-9 codes apply to this condition? Indiana Subscriber Answer: According to ICD-9, use 780.02 (Transient alteration of awareness) when a patient experiences "temporary, recurring spells of reduced consciousness." Given your description, this is the best diagnosis for On the claim, report 99202 (Office or other outpatient visit for the evaluation and management of a new patient, which requires these three key components: an expanded problem-focused history, an expanded problem-focused examination, and straightforward medical decision-making) with 780.02 appended. Exception: You noted that the patient did not "black out" during any of the episodes. If the patient actually lost consciousness during these altered states, report 99202 with either 780.2 (Syncope and collapse), which includes blackouts, or 780.09 (Alteration of consciousness; other), which includes unconsciousness.
the patient.
Primary Care Coding Alert
- Use Inside Info to Prevent HPI Rule Hunt
In CMS's eyes, this element is your FP's duty Although support staff might want to [...] - Risk Audit by Coding Same-Date E/M, Critical Care
Heed this warning: Medicare mentions -discretionary reviews- on 99291 claims You-ll need to be sure [...] - Clean Up 99291 Claims by Keeping Up With Transmittals
Medicare now excludes critical care and an ED E/M on same date CMS has released [...] - You Be the Coder:
Complex or Simple Nosebleed Treatment?
Question: An established patient reports to the FP with a bleeding left nostril. She tells [...] - Pediatric Coding Corner:
Using 2 ICD-9 Tips to Get Paid for 95930 and E/M
Careful: Sometimes a well-check diagnosis isn't the way to go You-ll get paid the first [...] - Reader Questions:
Include Anesthesia in 1 Circ Type
Question: When an FP performs a neonatal circumcision without anesthesia, a consultant said I should [...] - Reader Questions:
Code Differently for 'Alterations' and 'Blackouts'
Question: A 25-year-old new patient reports to the FP for his initial visit. He says [...] - Reader Questions:
ICD-9 Code Choice Depends on Apnea's Cause
Question: The physician performs a level-two E/M on a new patient with sleep issues. The [...] - Reader Questions:
Freeze at 327.XX ICD-9 Section for Sleep Paralysis
Question: An established patient reports to the FP reporting that shortly after waking up in [...] - Reader Questions:
If Physician Makes No Incision, Opt for E/M
Question: A patient presents to the FP with shards of glass from a shattered light [...]
