tci ED Coding & Reimbursement Alert - 2001 Issue 12

Reader Question: Coding Unfound Conditions

Question: What diagnosis codes should we assign when a patient presents with a suspected problem, but no problem was ultimately identified? For instance, a pediatric patient was recently brought in because the mother thought he had swallowed a marble but, in actuality, that hadnt happened. Our physician performed an examination and noted that this was a well child exam. Is this correct?Kansas Subscriber  Answer: Classifying cases like this as well-child visits is not appropriate. In fact, most payers strongly discourage the ED from being used for routine care. Instead, this situation should be coded with a code...

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