Wiki Risperidone injections in office visit - diagnosis code?

[j_oania@yahoo.com]

I'm having trouble coming up with a primary DX for this type of encounter.
Would I use ICD Z51.81 for visits where the patient comes in for re-evaluation of Schizophrenia, and the medical provider decides to administer Risperidone?
The same provider also addressed anxiety, tobacco use, and upon examination, found a serous bullae.

Right now I have this, but I'm thinking this will get denied because the primary DX is a mental health disorder:
99213 ---- F25.1, F41.9, Z72.0, L13.8
96372 ---- F25.1

 

[Sskinner37@gmail.com]

Hi Jasmin,

I'm having trouble coming up with a primary DX for this type of encounter.
Would I use ICD Z51.81 for visits where the patient comes in for re-evaluation of Schizophrenia, and the medical provider decides to administer Risperidone?
The same provider also addressed anxiety, tobacco use, and upon examination, found a serous bullae.

Right now I have this, but I'm thinking this will get denied because the primary DX is a mental health disorder:
99213 ---- F25.1, F41.9, Z72.0, L13.8
96372 ---- F25.1

Looking at this maybe use Encounter for Prophylactic Measures, unspecified (Z29.9) as primary since this is the reason for the injection.

Hope this works

Stacey Skinner, CPC

 

[mitchellde]

I am not sure why you feel this would deny with the schizophrenia dx code. The medical necessity for Risperidone is the schizophrenia. It is not prophylactic and it is not drug monitoring. You would need to list the code for schizophrenia first listed and link it to the injection, you stated that the psych dx was the reason for the visit and the reason for the injection. If you are not a psych provider then it is possible the payer will not pay unless you can justify why they are not being treated for this dx by a psych provider