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Pediatric Coding Alert

Reader Question:
Check Age Requirements for 778.6

Question: We billed ICD-9 778.6 for a 6 year-old male patient, but the insurer is stating that this code cannot be used for a child this age. The child was seen for a hydrocele. Is there a problem with this ICD-9 code, and if so, can you please let me know which ICD-9 I should use?Georgia SubscriberAnswer: Some insurers will only reimburse 778.6 (Congenital hydrocele) for an infant patient. Depending on the documentation, a code in the 603 range (such as 603.9, Hydrocele unspecified) might be a better bet.

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