Primary Care Coding Alert
Use Single Dx in This Colitis Coding Conundrum
Question: Our provider documented a patient as having both diarrhea and colitis. Do I assign codes to both conditions, or is only one code used in this case? And if I do code the diarrhea, do I use R19.7 or K59.1? New Jersey Subscriber Answer: First, you can determine the difference between the two diarrhea codes — R19.7 (Diarrhea, unspecified) and K59.1 (Functional diarrhea) — by looking at the code groups they are assigned under. Code K59.1 describes an intestinal condition characterized by its frequent recurrence, whereas R19.7 describes a symptom. However, in this particular situation, you would not use either of the codes. That’s because diarrhea is one of the symptoms of colitis, which is coded to K52.9 (Noninfective gastroenteritis and colitis, unspecified) when otherwise unspecified. That’s why both R19.7 and K59.1 are listed as Excludes1 codes for K52.9. Additionally, you would not use R19.7 as ICD-10 guideline II.A instructs you not to use “codes for symptoms, signs, and ill-defined conditions from Chapter 18 … as principal diagnosis when a related definitive diagnosis has been established.” In this case, colitis is a definitive diagnosis, making use of R19.7 unnecessary.
Primary Care Coding Alert
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Use Single Dx in This Colitis Coding Conundrum
Question: Our provider documented a patient as having both diarrhea and colitis. Do I assign [...]
