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Meet the Panelists | Submit Your Question
Q: My physician is a gynecologist, and she is going to start performing pelvic u/s and trans vag u/s in our office. She has an u/s tech doing the u/s and she is going to interpret the results. She owns the ultrasound equipment. Can I code the actual u/s, the interpretation and the equipment? I have been doing some research and the modifier TC is used for only hospitals. Can a physician use this as well? I wanted to code 76830, 76830-26, 76830-TC. It doesn't look right so hopefully you can help.
A: You would use the global code 76830 without a modifier. The AMA book, "Coding with Modifiers" says that if a provider "owns the equipment, interprets the test, and pays the technologist, modifiers TC and modifier 26 do not apply and the procedure is reported without a modifier."
Amy Hodges, CPC, CPC-I
Q: I have an ER facility ICD-9 coding question. A patient is triaged by the nurse and leaves without being seen by a physician. What would be the acceptable ICD-9 code for this visit?
A: The common practice is to assign a diagnosis code for the chief complaint and assign the discharge status as 07 - left against medical advice or discontinued care. The status includes not only patients who leave AMA but also includes patients who leave before triage, or are triaged and leave without being seen by a physician.
Kathy Myrick, RHIT, CCS
Q: How would Diabetic lipodystrophy be coded? 250.80 and 272.6?
A: I think you are on the right track here. I would recommend using 250.80 and 272.6. This seems most appropriate.
Dawson Ballard, Jr., CCS-P, CPC
Q: If you have a patient with sickle cell crisis with anemia, do you still code the 285.9 along with sickle cell crisis?
Clarification Question: Does the patient have sickle cell anemia or unspecified anemia?
Response to Clarification: sickle cell anemia.
A: You would only code the sickle-cell crisis code 282.62 and not the code 282.60 for the anemia. Under code category 282.6X it states under the heading for Sickle-Cell Disease "Sickle-cell Anemia." This means the "sickle-cell anemia" is included in those codes. When I grouped both codes together I received an edit stating that you would not code both codes together and to only code the 282.62 for the sickle-cell crisis (ICD9RelationalEdit30).
Mary Mills, RHIT, CCS
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Coding Clinic is published quarterly by the American Hospital Association
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