Post traumatic seizures or acute symptomatic seizures following a head injury in centers for disease control and prevention release, the ICD-9CM coordination maintenance committee explained that the unique code for this type of a seizure is important because these patients need to filed for treatment as well as prognostic and epidemiologic consideration.
The result is the creation of ICD-9 medical code 780.33 for post traumatic seizures will further specify this type of seizure. In 2010, you had to look at the 780.3X sub-category in order to report a patient’s symptoms.
Many states have created laws related to care for post-TBI or traumatic brain injury patients. The state laws and diagnosis code changes coincide with the CDC campaign aimed at prevention in early diagnosis of TBI.
“These laws and education have had a huge impact on family medicine physicians who see patients who have had head injuries from sports or falls, indigent populations and returning military personnel”, explains Marcella Bucknam.
As with other kinds of seizures, post-traumatic seizures may not occur until weeks or months after the injury. When the seizure may be considered a late effect to the head injury. But before you code for a seizure as a late effect, you'll need documentation that shows the casual relationship between the current condition symptom or sign and the underlying etiology.
The bottom line is rely on documentation to determine whether to also code one of the late effects ICD-9 medical code such as 907.0 which is the late effect of intracranial injury as a second diagnosis.
So let's go ahead and test yourself. A 17-year old, male, new patient presents with spells of blanking out over the last several weeks. The patient reports this started a few days after he was hit in the head with a softball.
The FP performs a comprehensive history and exam focusing on possible late effects of the head injury. During moderate complexity medical decision making, the FP orders neurologic testing and request an evaluation from a local TBI clinic. The final diagnosis is mild seizure status post TBI.
Beginning October 1, you should have submitted the following for this encounter: 99204 with E/M with 780.33 appended to that 99204 to represent the seizures, 9070 appended to 99204 as well to represent the late effect status of the injury and then E007.3 to represent the cost patient’s injury.
Now, the C-code is optional. It does not affect payment. It does as far as accident insurance injury as well as for state registry information and data collection.
When the physician diagnosis jaw pain, you can choose 784.92 for the encounter. Previously, there was no specific code for this. A possible code which was a lump sum code is for 526.9 for unspecified diseases of the jaw.
The more specific jaw pain code could help support some complaints that may be related to the dental problems that wouldn't have been covered under the 526 general code.
You'll get to be a whole lot more specific when reporting fecal incontinence this fall. The single ICD-9 medical code 787.6 gave way to four new options that describe fecal incontinence problematic symptoms such as fecal smearing, fecal urgency and incomplete defecation.
When October 1 rolls around, you can no longer report just 787.6 as ICD-9 deleted that. If you're getting denials for invalid code entries, make sure that you're adding on that fifth digit so that you're reporting these new medical codes.
Now, some payers are slow to adopt these new codes so you might have been all right with using that through January 1 of the New Year. Some payers are even indicating that they will not be ready for the new code until June of 2011.