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meenda

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Can anyone help me with virus codes with ICD10? I work for a pediatrician, and she often chooses Viral infection as a DX. First I was using B97.89, but UHC and other commercial insurances denied. So then I started using B34.9 but they started denying that also because it's unspecified. I just recently asked the Dr to stop using virus at all, and I will just code the symptoms. But there has to be a code that insurances accept. We don't send out respiratory cultures for everyone, so it's hard to know what virus is causing the illness. I am at a loss.....Has anyone had any luck with VIRAL ILLNESS as a dx???
 
The B97 codes are all secondary only codes see the note in your code book. The B34 codes are for virus of unspecified site, and B34.0 is unspecified virus of unspecified site. This may be just too unspecified to be accepted. If your provider cannot document anymore that virus, I would request symptoms for coding.
 
If its just the common cold the doctor should just document that instead. Id ask the physician if that's what they meant. If its just sore throat have them document that. If he/she thought it was anything else there would be an order for labs.
 
meenda said:
Can anyone help me with virus codes with ICD10? I work for a pediatrician, and she often chooses Viral infection as a DX. First I was using B97.89, but UHC and other commercial insurances denied. So then I started using B34.9 but they started denying that also because it's unspecified. I just recently asked the Dr to stop using virus at all, and I will just code the symptoms. But there has to be a code that insurances accept. We don't send out respiratory cultures for everyone, so it's hard to know what virus is causing the illness. I am at a loss.....Has anyone had any luck with VIRAL ILLNESS as a dx???
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The description for code B97.89 is "Other viral agents as the cause of diseases classified elsewhere" which is a NEC type code

"Viral infection" is a NOS type code. Always trust your index in your manual. that is truly your best friend. It will have your back in the end.

When looking up the term, the main term Infection, and then Viral will lead you to B34.9. Verify this in the tabular section.

On a side note, the doctor should be queried for more information.
 
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