You Be the Coder:
Annual ECG and Chest X-Ray
Published on Sat Dec 01, 2001
Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.
Question: Which diagnosis codes should I use for an annual ECG for a patient with chronic asthma that is abnormal for the first time but with no history of heart disease? Also, what are the diagnosis codes for an annual chest x-ray as a screen for lung cancer for a current smoker with COPD in the absence of signs and symptoms of cancer?
Texas Subscriber
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Answer: A screening is often misinterpreted by physicians and coders. Patients may have chronic conditions that can worsen or may affect other organs. In this sense, although you are "screening" the patient for progression of the disease, it should not be reported as a "screening" test/study. A patient with chronic asthma and a previous abnormal ECG requires further ECG testing to determine if the asthma has progressed and is now putting additional strains on the heart. In this case, the reason for the ECG is an abnormal ECG (794.31) with the underlying condition of asthma (493.xx).
The chest x-ray scenario is different depending on the reason for ordering the study. If the physician wants to check the disease status of a patient with COPD (496), COPD is the reason for the x-ray. If the x-ray is being done because the patient is a smoker and the physician is looking for early signs of lung cancer, the screening code is V76.0 (special screening for malignant neoplasms, respiratory organs) in addition to the code for smoking, 305.1 (tobacco use disorder) and COPD (496). | |
