tci ED Coding & Reimbursement Alert - 2009 Issue 10

READER QUESTIONS: 'Alterations' Do Not Equal Unconsciousness ICD-9s

Question: A 55-year-old patient reports to the ED, saying that for the past three weeks, he has "zoned out" for no reason several times, but did not lose consciousness during any of the episodes. The physician provides a level three E/M, diagnoses "episodic abnormality of consciousness; etiology uncertain," and refers the patient to a neurologist. Which ICD-9 codes apply to this condition? Oregon Subscriber Answer: According to ICD-9, use 780.02 (Alteration of consciousness; transient alteration of awareness) when a patient experiences "temporary, recurring spells of reduced consciousness." Given your description, this is the best diagnosis for...

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