Wiki Behavioral withdrawal versus substance dependency diagnosis codes

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Can someone explain the difference between behavioral withdrawal codes (291.xx/292.xx) and dependency codes (303.xx/304.xx).

I work in a sub-acute rehab treatment facility and it appears our claims will be denied or paid by our payers depending on whether the withdrawal or dependency diagnosis code is code as primary.

thanks for your help
dante
 
291 codes are for the acute reactions to withdrawal:
Acute alcoholic, psychotic condition characterized by intense tremors, anxiety, hallucinations, and delusions.
An acute organic mental disorder induced by cessation or reduction in chronic alcohol consumption. Clinical characteristics include confusion; delusions; vivid hallucinations; tremor; agitation; insomnia; and signs of autonomic hyperactivity (e.g., elevated blood pressure and heart rate, dilated pupils, and diaphoresis). This condition may occasionally be fatal. It was formerly called delirium tremens.
292 are also for the acute conditions
Physiological and psychological symptoms associated with withdrawal from the use of a drug after prolonged administration or habituation; the concept includes withdrawal from smoking or drinking, as well as withdrawal from an administered drug.
Processes and symptomatic effects resulting from abstinence from a chemical agent or medication. Used for human or animal populations.
303 and 304 are the chronic long term
A chronic disease in which a person craves drinks that contain alcohol and is unable to control his or her drinking. A person with this disease also needs to drink greater amounts to get the same effect and has withdrawal symptoms after stopping alcohol use. Alcoholism affects physical and mental health, and can cause problems with family, friends, and work.
A disorder characterized by a pathological pattern of alcohol use that causes a serious impairment in social or occupational functioning.
A primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking, most notably denial. Each of these symptoms may be continuous or periodic.
Drug dependence - replaced the term "drug addiction" and is defined as a state, psychic and sometimes also physical, resulting from the interaction between a living organism and a drug, characterized by behavioral and other responses that always include a compulsion to take the drug on a continuous or periodic basis in order to experience its psychic effects, and sometimes to avoid the discomfort of its absence. Tolerance may or may not be present. A person may be dependent on more than one drug.
 
Hi Debra,
So for a rehab treatment center, does it matter for billing and reimbursement whether the withdrawal code or dependency code is coded first (primary).....
dante
 
If they are there for acute symptoms of withdrawal then you would code those first. If the withdrawal has passed and they are there for rehab only then use only the dependency codes.
 
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