Chris and all -
Since this child was seen for a suspected exposure to a hazardous material
(button battery) V87.39,Contact with and (suspected) exposure to other
potentially hazardous substances would have been the appropriate principal
code. V82.5, Special screening for Chemical poisoning and other
contamination would be an appropriate contributing (secondary) code.
V71.89, Observation and evaluation for other specified suspected
conditions (other) could also be used as a contributing code.
Two important point to remember in the ED:
1) We don't do "well child checks" so the V20 code set (Health supervision
of infant or child) shouldn't be used
2) Yes, V-codes can be used as primary codes and yes you can get paid for
Signs and symptoms complaint based diagnosing is perfectly acceptable, you
don't need a "final" diagnosis. The V29 (newborn), V71 and V87 codes are
there to show that you were concerned about a problem that didn't have a
specific complaint, e.g. "He choked on the battery", and where there are
no physical finding.
Hope this helps.
Jeffrey Linzer Sr., MD, FAAP, FACEP
Associate Professor of Pediatrics and Emergency Medicine
Lead Physician for ICD-10-CM Conversion
Children's Healthcare of Atlanta
Associate Medical Director for Compliance
EPG/Division of Pediatric Emergency Medicine
On 2/26/13 12:20 PM, "Christopher Kelly" <[log in to unmask]> wrote:
>Question for the group -
>We recently had a patient encounter where a young child was found with 2
>small button batteries in his mouth, a third one missing. He was
>completely assymptomatic. The child was examined and had x-rays and
>luckily no battery was seen. My problem is the doc coded the patient as a
>well-child exam, a V-code, and the insurance company wont pay and now the
>family is stuck with a $1000 bill.
>My question is, how would you have coded this? I found Foreign body
>entering through orifice - mouth (935.0), but didn't know of any other
>loop holes. Parental anxiety, another V-code also doesnt help me out.
>Chris Kelly MD
>Pediatric Emergency Medicine
>New York Methodist Hospital
>For more information, send mail to [log in to unmask] with the
>message: info PED-EM-L
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