Wiki Coding for illness that resolved by time pt got to office

[ErinPDX85]

Hi there,

My office has a question regarding the correct way to code for a particular situation. Patient comes in complaining of fever with no other symptoms. When doctor examines them they find no evidence of fever or anything else wrong with the patient. My thought is to code Z71.1 - Person with feared health complaint in whom no diagnosis is made. Some other thoughts in my office would be to bill for fever because that is what brought the patient in to the office in the first place and is the chief complaint.

Any input would be greatly appreciated!

 

[lorenc00]

Fevers can fluctuate hour to hour. We, on the Coding Education Team at the Massachusetts General Physicians Organization, would code this situation to the chief complaint of 'fever'.

 

[ErinPDX85]

Thank you! That helps! I will pass this along. In other situations, like where a patient thinks they have a lump in their breast but the provider finds no lump, would this fall under the Z71.1? Or if they said they had X but provider cannot find no evidence of X, would that fall under Z71.1?