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Valid Diagnosis Codes for Patient's Age

Lori Posted Thu 03rd of May, 2012 17:40:03 PM

Hello,
We have come across a situation where a code is not valid for the patient's age. We had a patient come in for their 2 month well visit and billed a V20.2 (well baby exam), 706.3 (seborrhea) and 652.23(breech present-antepart). I called the insurance company and they told me that it was possibly the seborrhea code because the others were appropriate for the patient's age. Where would we find the appropriate code for the patient's age and/or how do we find out what the appropriate code is? Thanks for any input about this matter

SuperCoder Answered Thu 03rd of May, 2012 19:07:38 PM

In every page of ICD-9 tabular list at the bottom you will see symbols. There are four age categories for diagnoses in the FY2011 Definitions of Medicare Code Edits(MCE). The symbol P represents Pediatric: Age range is 0-17 yesrs inclusive. Hope this will help you in finding the correct code.

Lori Posted Thu 03rd of May, 2012 19:47:01 PM

We thank you for this information. We will definitely for this in our ICD-9 book.

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