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March 29, 2023

Diagnosis Coding for Tick Bites

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Question:

Why is it so hard to have correct diagnosis coding for tick bites? And, how is it coded?

Answer:

The search function in electronic health records leads clinicians astray. And, diagnosis coding for tick bites  requires two diagnosis codes, because it is an injury. It requires a code from the injury chapter in the first position, that describes the injury and location. And, a code from the external cause chapter that describes how the injury occurred. Does that seem like overkill? Well, it’s ICD-10-CM.

The provider searches for the word “tick” and in many systems, up pops W57.xxxA. Someone helpful has changed the ICD-10 definition to include the word tick, although the ICD-10 definition is “Bitten or stung by nonvenomous insect and other nonvenomous arthropods, initial encounter.” A tick is an arthropod.

But, the problem with that is, W57.xxxA is an external cause code. It may not be submitted in the first position on the claim form, and often it is the only code selected by the provider. The first code should be an S code that describes the location of the bite, such as S70.362A “Insect bite (nonvenomous), left thigh, initial encounter.”

So, it isn’t that it is difficult to code for a tick bite, it’s that there are two steps and the super easy, quick search leads providers to assign the wrong code.

While you’re thinking of diagnosis coding, it’s a good time to review the rules for coding screening labs.

Can you screen for an existing condition? | Diagnosis Coding for Lab Services

 

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Last revised July 27, 2022 - Betsy Nicoletti
Tags: ICD-10 coding

CPT®️️ is a registered trademark of the American Medical Association. Copyright American Medical Association. All rights reserved.

2023 E/M reference sheets

These handy quick reference sheets included at-a-glance MDM requirements for office, hospital, nursing home and home and residence services. And, a bonus sheet with typical time for those code sets. Sign up for Betsy’s monthly newsletter to download these reference sheets and share them with your practitioners.

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2023 E/M guidelines for hospital, nursing facility, home and residence services | Webinar

Effective January 1, 2023, the AMA has revised the definitions and guidelines for hospital and other E/M services, including ED visits, nursing facility services, home services, and domiciliary care codes. Also, coding for prolonged care services gets another overhaul with revised codes and guidelines. Watch this webinar about all these changes.

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Our mission is to provide up-to-date, simplified, citation driven resources that empower our members to gain confidence and authority in their coding role.

In 1988, CodingIntel.com founder Betsy Nicoletti started a Medical Services Organization for a rural hospital, supporting physician practice. She has been a self-employed consultant since 1998. She estimates that in the last 20 years her audience members number over 28,400 at in person events and webinars. She has had 2,500 meetings with clinical providers and reviewed over 43,000 medical notes. She knows what questions need answers and developed this resource to answer those questions. For more about Betsy visit www.betsynicoletti.com.

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