Based in the U.S., Outsource Strategies International (OSI) provides medical billing and coding services for clinics, physician groups, surgical centers, general practitioners and hospitals. We make your reimbursement process easier by streamlining everything from patient scheduling and insurance verification to coding, billing, and collections.In today’s podcast, Meghann Drella, one of our senior solutions managers, discusses common warm weather diseases and the ICD-10 codes to report them.
Hello and welcome to our podcast series. My name is Meghann Drella and I am a senior solutions manager here at Outsource Strategies International.
Today, I will be discussing how to report warm weather diseases.
Warm weather diseases are caused mainly due to prolonged or intense exposure to hot temperatures. Exposure to such extreme heat can make a person seriously ill. The likelihood of illness also depends on factors such as physical activity, clothing, wind, humidity, working and living conditions, and a person’s age and state of mind. Some common warm weather diseases are insect bites, poison ivy, swimmer’s ear, and heatstroke. Physicians treating such diseases need to use the correct ICD-10 codes to report diagnoses.
It is common during summer to see and experience various bites and stings by insects, spiders, snakes, animals and marine life. Most of the time, these bites and stings do not cause serious problems. However, in rare circumstances, certain bites and stings can cause severe illness or even death in people who are sensitive to the venom.
When you are approached by a patient who has been bitten by an insect, first you have to verify venom before you report that bug encounter and finalize your code.
After the verifying check, start your search for codes in the ICD-10-CM Index to Diseases and Injuries, where the index entry for Bite(s) has many subentries based on site, such as ankle, arm (upper), chin, and so on. There is a separate subentry for “insect,” but it confirms that site is your best bet by instructing you to “See Bite, by site, superficial, insect.”
Coding for a non-venomous insect bite is not the same as coding for a venomous spider bite, which you’ll report using the code “T63.3” (Toxic effect of venom of spider)
A number of people suffer after coming into contact with poisonous plants such as poison ivy, poison sumac, and poison oak, every year. The ICD-10-CM code for such contact is “L23.7” (Allergic contact dermatitis due to plants, except food).
In some cases, the dermatitis may spread and cause significant issues like skin infections. Using additional ICD-10-CM codes for the infections or other issues documented may help support reporting a higher-level E/M code or procedure code for the specific encounter.
Another common warm weather disease is swimmer’s ear, also known as Otitis externa or external otitis, which is an inflammation of the outer ear and ear canal. The inflammation can be secondary to dermatitis only, with no microbial infection, or it can be caused by active bacterial or fungal infection. In either case, but more often with infection, the ear canal skin swells and may become painful or tender to touch. The codes to document this illness start with “H60.33” (Swimmer’s ear).
The least common but most severe heat-related illness is heat stroke. Currently, T67.0- divides into three codes that differ based only on encounter type (initial, subsequent, and sequela). More specific ICD-10 codes for heat stroke and sunstroke become effective on October 1, 2019.
Knowing the highly specific ICD-10 codes related to documenting warm weather diseases such as insect bites, poison ivy, swimmer’s ear and heatstroke is important for healthcare providers.
Hope this helps, but always remember that documentation as well as the thorough knowledge of payer regulations and guidelines is critical to ensure accurate reimbursement for the procedures performed.
Thank you for joining me and stay tuned for my next podcast.