Wiki ICD 9 coding for resolved dx

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maranieves

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How would be the most appropriate way to code for let's say a URI that has resolved? Or if you have a patient that had a UTI and came back in for a recheck and it was cleared. Do you still code it as what the patient was previously diagnosed with or should it be coded as history of UTI? :confused:
 
most conditions that have resolved should be coded with V codes for follow up. an infection is considered a visit for the infection until the visit after it has cleared.
For instance the patient presents with symptoms that is diagnoses as a UTI, this is coded as either the symptoms or the UTI, when the followup is scheduled it is assumed it is for a still present UTI, and is code as a UTI, if the provider documents it as cleared but still wants the patient to return for another follow up then the third visit is coded as a follow up V67.x since the provider cleared it on the second encounter.
However conditions that we know have cleared such as appendicitis, when the patient returns for follow up, we know this is no longer present when there was an appendectomy so it is coded as follow up.
I hope this was not too confusing.
 
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