tci Medicare Compliance & Reimbursement - 2022 Issue Q4

Reader Questions: Know the Facts on Coding Common Colds

Question: With cold and flu season already ramping up, we are seeing a disordinate amount of patients presenting with cold symptoms. We are confused about what to report. If a patient has a sore throat and a cold, do we code both conditions? Massachusetts Subscriber Answer: No. In situations like this, you report only one of the conditions. Expert coding tip: A common cold is reported with J00 (Acute nasopharyngitis [common cold]). You’ll notice several Excludes1 instructions for the various conditions typically accompanying a cold: J02.- (Acute pharyngitis) J02.9 (Acute pharyngitis, unspecified) J09.X2 (Influenza due...

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