Re: Code Question

[Guest guest]

>, Hi, I was just wondering if you could tell me where you found

the

>explanations for the insurance codes? I just went to a website to

see what

>the codes were that are being billed to my insurance, it just

happens that

>the code they are using is 315.4 and according to the ICD-9 website,

it

>says that 315.4 is a developmental delay... and apraxia is 784.69

according

>to that place. I would really appreciate any help, I am trying to

find out

>exactly what and why they are billing it to my insurance that way

when he

>has a dx of apraxia. Thanks! Kari Belle

>

>

Hi Kari:

The code 315.4 generally refers to motor delays, and indicates a

developmental origen (the 315 prefix is used for developmental and

learning disorders).

Codes beginning with 7 generally refer to signs and symptoms, and

most doctors and therapists are advised by their coding gurus to

avoid them, as they can sometimes cause reduced reimbursement (we all

want to get paid fairly...).

Some insurances may not recognize the 784.69 code, and reject the

claim on this basis. I am cautious in my practice to always give

multiple dx codes, describing the full symptom complex of the child.

Larry Laveman, MD

Medical Consultant, CHERAB

http://www.apraxia.cc

[Guest guest]

, I'd chart it as a flare up and probably code it as a 905.7, Late effect of strain/sprain....if that was what the patient was stationary from.

Don White, RN, DC

In a message dated 12/15/2011 5:47:18 P.M. Pacific Standard Time, drscott@... writes:

Patient medically stationary from an injury for a month.Neck pain returned identical to previous pain.Required 3 treatments. (Who da man!)Is there a specific code for aggravation?Or is it an exacerbation?Or is it the foundation of cremation leading to contamination of the information....-The Right Reverend Jessie !!!OK, forget the last one.Or do I just chart it as a flare up and send it in?I was always in detention during coding class.Eating paste in the back room, etc.-- E. Abrahamson, D.C.Chiropractic physicianLake Oswego Chiropractic Clinic315 Second StreetLake Oswego, OR 97034503-635-6246Website: http://www.lakeoswegochiro.com