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Primary Care Coding Alert

READER QUESTIONS:

Probable H1N1 Is Not the Same as Diagnosis

Published on Thu Nov 19, 2009

Question: Our physician is currently handling a probable case of H1N1. He wants me to use the old influenza codes (487.x), but I'm pretty sure there's already a new ICD-9 code out for H1N1. Am I right? Texas Subscriber Answer: No, ICD-9 guidelines instruct providers to use 487.x (Influenza) for probable, possible, or suspect cases of H1N1. As long as the infection is not confirmed as H1N1, then the previous influenza codes 487.x remains valid. Rule: Coding should be based on the provider's diagnostic statement that the patient has novel H1N1 (H1N1 or swine flu) influenza. "In this context, 'confirmation' does not require documentation of positive laboratory testing specific for novel H1N1 influenza," according to the 2009 ICD-CM Official Guidelines for Coding and Reporting (www.cdc.gov/nchs/data/icd9/icdguide09.pdf). Consider that H1N1 (488.1, Influenza due to identified novel H1N1 influenza virus) is only one of several strains of influenza A. Moreover, the majority [...]
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