Primary Care Coding Alert

Question: Our FP evaluated a newborn baby whose mother said that the child would often begin to choke while being fed and would then spit up the milk. I want to know what diagnosis code I should report for the E/M encounter that our clinician performed on the baby. I was looking through the codes and could only come up with T17.320A. Is this appropriate or should I report some other code?

Texas Subscriber

Answer: Although T17.320A (Food in larynx causing asphyxiation, initial encounter) looks like an appropriate choice to report because the descriptor mentions “food in larynx causing asphyxiation,” you should actually look at an entirely different set of codes. Since the baby is experiencing recurring trouble when she is being fed, it better to report the diagnosis as a feeding difficulty rather than to report T17.320A for the encounter. T17.320A suggests an event-specific injury rather than an ongoing feeding problem.

You have not made any mention about the age of the infant in your question. If the child is an infant not older than 28 days, then you report the diagnosis with P92.1 (Regurgitation and rumination of newborn). If the child is over 28 days old, you can report R63.3 (Feeding difficulties) instead of P92.1.