Wiki Diagnosis code for rule out crohn's

[mwarburton]

I know that there are no codes for rule out however the patient came in and had a capsule endoscopy as she is suspected of having crohn's and with medicare you are only allowed to bill for certain diagnosis codes in order for the test to be paid. We have used 793.4 as she had some abnormal findings on her ct scan and this is one of the codes payable by Medicare but I still need a primary code to use with this one. Does anyone have any suggestions? I dont think I can use the 555.9 as she hasnt been diagnosed with crohn's yet. Thanks.

 

[pennysueorr]

I'm guessing that the patient must have some signs or symptoms to suspect the Chrons?

 

[mwarburton]

Yes he is checking for inflammation she has been having epigastric pain on and off and she has had an EGD with polyps in the stomach that were benign.

 

[eadun2000]

Then I would use the 789.06 as it is the reason for the study. Just my opinion.

 

[elenax]

I would go with the signs or symptoms too.

 

[aguelfi]

I used to use teh signs or symptoms unless the pt had another diagnosis that led to the study like abd pain