Pulmonology Coding Alert

Question: Our pulmonologist performed multiple arterial blood gas (ABG) interpretations within a 24-hour period only when levels were abnormal. He continued ABG readings until the findings turned up normal. Which ICD-9 codes should we use for interpreting the normal ABGs? Should we use the chief complaint or the symptom for which the patient was originally tested?

Florida Subscriber

Answer: When you report the diagnosis code, you should consider several factors. If your pulmonologist confirms a definitive diagnosis after he reviews the test results, you can use the definitive diagnosis to submit the claim. If the test result is normal, you can report the original reason for performing the tests.

For example, your pulmonologist may have performed the original test to assess the patients hypoxemia (799.0). As the patients course of treatment progressed, the hypoxemia resolved. Your pulmonologist could have reported the testing during the treatment with either or both hypoxemia or abnormal ABGs (790.91). When the problem resolves and the test comes back normal, report the reason for the test: The previous test was abnormal and the patient was still hypoxic at that time.