The TrustHCS education team provides regular in-service coding tips to our team of credentialed coding professionals. Among those in-service opportunities are coding clinics that happen for our employees on Thursdays’, weekly. Dr. Nena Scott and her expert education and consulting team has composed several coding tips to help with your coding efforts. Below you will find an array of coding tips that you can incorporate into your coding career today.

 

 

Cannabinoid Hyperemesis Syndrome Associated with Excessive Cannabis

The coding clinic guidance on this topic provided the following code assignment advise:

 

R11.2 Nausea with vomiting, unspecified

Assign code from category F12, Cannabis related disorders, for a diagnosis of cannabinoid hyperemesis syndrome

The rationale providing in the coding clinic states, “Cannabinoid hyperemesis syndrome is the definitive diagnosis; however, since there is no specific code for this condition, the symptom code for nausea and vomiting should be assigned. The Official Guidelines for Coding and Reporting for Syndromes state, “In the absence of Alphabetic Index guidance, assign codes for the documented manifestations of the syndrome.”

When the pattern of substance use (i.e., dependence, abuse, or use) is not documented, query the physician for clarification.

Code T40.7X1A, Poisoning by cannabis (derivatives), accidental (unintentional), initial encounter.  The condition is not classified as an acute poisoning, since it is caused by heavy chronic marijuana use, not by a single use.”

 

 

Diabetic Manifestations Following Weight Loss Surgery                              

The coding clinic guidance for a patient that has type 2 diabetic polyneuropathy and no long requires medication for the diabetes after bariatric surgery and significant weight loss. The patient presented with ulceration on the right foot with acute osteomyelitis secondary to diabetic polyneuropathy.  The coding clinic provided the following code assignment advise:

 

E11.42 Type 2 diabetes mellitus with diabetic polyneuropathy

E11.69 Type 2 diabetes mellitus with other specified complication

E11.621 Type 2 diabetes mellitus with foot ulcer

M86.171 Other acute osteomyelitis, right ankle, and foot

L97.511 Non-pressure chronic ulcer of other part of right foot limited to breakdown of skin

Z98.84 Bariatric surgery status, for the post status weight loss surgery

 

The rationale provided in the coding clinic states,The patient still has complications associated with the diabetes, even though glucose levels have normalized. Codes from category E11, Type 2 diabetes mellitus are required to capture the diabetic manifestations.”

 

 

Pregnancy with History of Genital Herpes

The coding clinic provided guidance for a patient with history of genital herpes symptom free, being treated with antiviral medications, admitted for delivery at 39 weeks.  Based on the coding clinic advise the following codes should be assigned:

 

O98.32 Other infections with a predominantly sexual mode of transmission complicating childbirth

A60.09 Herpesviral infection of other urogenital tract

 

The rationale provided in the coding clinic states,Although the patient is not on antiviral medication, transmission of the herpes virus is a risk to the fetus and therefore, the infection is coded as a complication of delivery.”

 

 

Bipolar Disorder and Recurrent Major Depressive Disorder

The coding clinic provided guidance for a patient diagnosed with bipolar disorder and major depressive disorder recurrent, mild.  Based on the coding clinic advise the following code should be assigned:

F31.9 Bipolar disorder, unspecified

 

The rationale provided in the coding clinic states,Bipolar disorder includes both depression and mania, and it is more important to capture the bipolar disorder. Therefore, a code for depression would not be reported separately.”

 

Additional information provided in the coding clinic question stated, “Category F31, Bipolar disease, has an “Excludes1” note for “major depressive disorder, recurrent (F33-),” and category F33, Major depressive disorder, recurrent, has an “Excludes1” note for “bipolar disorder (F31-).” Bipolar disorder includes both depression and mania, and it is more important to capture the bipolar disorder. Therefore, a code for depression would not be reported separately.”

 

 

If you have any coding questions that you need answered by our expert team, do not hesitate to email us at info@trusthcs.com and we will help you as quickly as possible!