dballard2004
True Blue
A mother brought her 2 year old child into the office with a complaint of being fussy. Upon exam, the provider found nothing wrong and administered a flu vaccine per the mother's request. The provider used code 780.91 (fussy infant/newborn) as the primary dx (along with V04.81 for the vaccine), but our billing edits rejected this code because of the patient's age.
Per ICD-9 guidelines, if you have no definitive diagnosis, you code signs and symptoms, which the provider did here, but code 780.91 is for an infant/newborn and a 2 year old child is not an infant or newborn (per our billing edits).
So how do we code this? Is code 780.91 correct, or should we go with V65.5 for feared complaint but no diagnosis made?
Thoughts?
Per ICD-9 guidelines, if you have no definitive diagnosis, you code signs and symptoms, which the provider did here, but code 780.91 is for an infant/newborn and a 2 year old child is not an infant or newborn (per our billing edits).
So how do we code this? Is code 780.91 correct, or should we go with V65.5 for feared complaint but no diagnosis made?
Thoughts?