Neurology & Pain Management Coding Alert

Reader question: Consultation for a Brain-dead Patient

- Published on Fri, Oct 01, 1999
Question: Please give the correct code for inpatient consultation for a patient diagnosed as brain-dead.

St. Louis Subscriber

Answer: The correct code is 99255 (initial inpatient consultation for a new or established patient, comprehensive history and examination, and medical decision-making of high complexity), says Jere Roswech, CPC, a reimbursement specialist with the Carolina Cancer Center in Aiken, SC.

When you use Level 5 E/M codes like the 99255,
Roswech adds, you must give solid documentation to indicate the patient was in critical and unstable condition. The diagnosis code for brain death, 348.8 (brain death, calcification; fungus), is not particularly accurate but is the best ICD-9 code available for this scenario.

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