Pulmonology Coding Alert

Reader Questions:

Don't Lump Colds and Flu into One Test Option

Question: A patient presents with acute sinusitis and an upper respiratory infection that have resulted from a lingering cold. The pulmonologist wants to run a flu test. What diagnosis codes do I use? Should I report 87804 for the testing?Wisconsin SubscriberAnswer: You'll code 461.9 (Acute sinusitis, unspecified) for the firstlisted diagnosis, 460 for the second, and 465.9 (Acute upper respiratory infection NOS) for the third. Colds and flu share many symptoms, so it's not easy to tell the difference between them based on symptoms alone. Physicians conduct flu tests usually within the first few days of illness in order to tell if a person has the flu.When your pulmonologist orders a test on a patient for influenza, don't easily fall into reporting 87804 (Infectious agent antigen detection by immunoassay with direct optical observation; influenza). Base your code choice on the type of test, the method, and what product is used.When [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more