tci ED Coding & Reimbursement Alert - 2020 Issue Q3

Reader Questions:Nail Down Strep Test Diagnosis

Question: We recently ran a rapid strep test on a young patient who came in complaining of a sore throat. The nurse who administered the test used R07.0 in the electronic health record (EHR). The test came back negative, and the doctor documented that the patient had a viral sore throat. How should we bill the strep test — with the R07.0 or with a J02.- code? Hawaii Subscriber Answer: Typically, you would report J02.9 (Acute pharyngitis, unspecified) to reflect the patient’s chief complaint of a sore throat in the absence of a more...

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