ICD-10 Challenge - Critical Care

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saj402
Posts: 7
Joined: Thu Jul 25, 2013 11:16 am

Fri Mar 20, 2015 9:31 am

Dx T63.452, toxic effect of venom, could better support Critical Care services. R68.89, other general symptoms is pretty vague.
maryanne
Posts: 11
Joined: Fri Mar 20, 2015 10:49 am

Fri Mar 20, 2015 10:51 am

I agree, R68.89 seems too vague. The toxicity due to hornets seems more appropriate (T63.452A)
charris
Posts: 1
Joined: Mon Jun 02, 2014 8:28 am

Fri Mar 20, 2015 11:17 am

Only the T63.452A would be used for critical care. The diagnosis must be severe enough to endanger one or more of the vital organ systems. General systems are not usable for critical care visits. Allergic reactions to hornets can be a threat to life.
djfreedman
Posts: 3
Joined: Mon Jan 21, 2013 10:42 am

Fri Mar 20, 2015 11:47 am

I agree looking at the two codes - Dx T63.452A, Toxic effect of venom of hornets, intentional self-harm, better supports Critical Care services. R68.89, other general symptoms is pretty vague and would not most likely cover critical care.
jfries1
Posts: 5
Joined: Sat Dec 27, 2014 11:57 pm

Tue Mar 24, 2015 9:05 am

Dx T63.452, toxic effect of venom, would better support Critical Care services. R68.89, other general symptoms, alone as a principal diagnosis is not specific enough to support critical care.
Shannon DeConda
Global Moderator
Posts: 53
Joined: Thu Apr 12, 2012 2:53 pm
Location: Melbourne, FL
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Fri Mar 27, 2015 9:17 am

RATIONALE:
The following is the answer to last weeks challenge and the rationale:
R68.89 Other general symptoms and signs: This ICD-10 code is not specific and on its own would not represent a medically necessary reason for critical care services
T63.452A Toxic effect of venom of hornets, intentional for self-harm, initial encounter: This code supports a basis for a potential need for critical care services.
Therefore T63.452A is the more likely code to support critical care. Note this code is required to have a 7th character which indicates the episode of care.
Thank you,
Shannon O. DeConda, CPC, CPC-I, CEMC, CMSCS, CPMA, CMPM, CPMN
Founder & President of NAMAS

Disclaimer: NAMAS cannot be held liable for any advice given that could have had a variable answer based on additional information.
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