Tammy Posted Fri 28th of October, 2016 08:12:27 AM
Patient came in to office on 7/11 had injection done. On 7/13 came back in due to redness on injection site had a reaction to tetanus vaccine. The provider used ( T50.A95A)
Claim went out with T88.1XXA and T50.A95A as secondary dx. but we are getting a denial stating dx inconsistent with procedure? what is the appropriate dx code? thanks.
Tammy Posted Mon 31st of October, 2016 08:04:08 AM
Please let me know. thanks.
SuperCoder Answered Tue 01st of November, 2016 07:57:15 AM
As per the above documentation:
Patient came in office for tetanus injection on 7/11.
Codes for injecting tetanus are: 96372 (Procedure) and Z23 (Diagnosis).
The documentation again states that the patient came back with complaint of redness on injection site which is the adverse effect of tetanus injection. However for this encounter diagnosis codes T88.1XXA and T50.A95A can only be billed with a E/M code.
Tammy Posted Wed 02nd of November, 2016 07:57:14 AM
Can T88.1XXA be a principal dx code?
SuperCoder Answered Fri 04th of November, 2016 02:59:54 AM
As per CMS guidelines for ICD-10 CM, both codes can be billed as a principal dx code or as a secondary dx code.