Primary Care Coding Alert

Question: Encounter notes state that the FP diagnosed a patient with hematuria. That narrows down my diagnosis choices, but how can I figure out which hematuria code to choose?

Louisiana Subscriber

Answer: You'll either have to check the notes for evidence specifying hematuria type or go ask the FP what type of hematuria he is treating.

You have three hematuria codes. Check out thisrundown on when to use each one:

• 599.70 (Hematuria, unspecified). Use this code ifyou cannot get any additional information on the patient's condition.

• 599.71 (Gross hematuria). If the FB finds blood visible to the eye in the urine, it is gross hematuria. "The only visible sign of hematuria is pink, red, or cola-colored urine -- the result of the presence of red blood cells. It takes very little blood to produce red urine, and the bleeding usually isn't painful. Bloody urine often occurs without other signs or symptoms," according to the Mayo Clinic (http://www.mayoclinic.com/health/blood-urine/DS01013).

• 599.72 (Microscopic hematuria). This code represents "urinary blood that's visible only under a microscope, and is found when your doctor tests urine for another condition," according to the Mayo Clinic.

Best bet: Use this information against the encounter notes to see if you can figure out the proper diagnosis yourself -- and then double check with the FP.

If you see evidence of other urinary tests on the claim, it could be microscopic hematuria. If the notes indicate that the urine was "pink," that might be your ticket to 599.71.