tci E/M Coding Alert - 2021 Issue Q4

You Be the Coder: You May Need Two Codes For This Navel Encounter

Question: An insurance company has just denied us for an umbilical granuloma, telling us that P83.81 is the wrong ICD-10 code. Is this true? Should we appeal, or is there another code we can use? AAPC Forum Participant Answer: The correct code choice in this situation is based upon the age of the patient and payer preference. According to the ICD-10 guidelines accompanying the Chapter 16 (Certain Conditions Originating in the Perinatal Period [P00-P96]) codes, you would use P83.81 (Umbilical granuloma) if the patient is younger than 28 days, as “for coding and reporting purposes, the...

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