I code for several Pediatricians that keep using 799.51 primary to 314.01 & 314.00. If the patient has a definitive diagnosis of ADD or AD/HD you should code 314.00 or 314.01 primary and you don't need 799.51 after it because you wouldn't code the symptoms if you have a definitive diagnosis, correct? Of what I have read, once the individual has been diagnosed with ADD or ADHD; this is considered a chronic condition that is treated with closely monitored medications and guidance.
They state the reason they use 799.51 is because the ADD and ADHD codes are 'Psych Codes' and you can't use them as primary. They also stated that they lose money if they use 314.00 or 314.01 as primary. I have researched many claims with 799.51 & 314.00 or 314.01 as primary and alot of times the 799.51 doesn't get paid at all. The 314.00 or 314.01 is paying the same amount as the 799.51.
Does anyone have any other concrete evidence/guidelines that I can share with my Pediatricians?
Thanks,
Shannon
They state the reason they use 799.51 is because the ADD and ADHD codes are 'Psych Codes' and you can't use them as primary. They also stated that they lose money if they use 314.00 or 314.01 as primary. I have researched many claims with 799.51 & 314.00 or 314.01 as primary and alot of times the 799.51 doesn't get paid at all. The 314.00 or 314.01 is paying the same amount as the 799.51.
Does anyone have any other concrete evidence/guidelines that I can share with my Pediatricians?
Thanks,
Shannon