Coding Guidelines for Urine Culture

Please consider putting a better description on the 780.99 diagnosis for "other general symptoms". I have seen that most coders don't research or index this properly to find that this is the code they should use for the culture that is ordered for the elderly bene that has mental status changes. I had access to a certified coder to help me index this situation. This code description just says "other general symptoms". Would you consider expanding the description on the NCD for code 780.99 to tell them more.... such as "use for acute mental status changes or behavior changes in elderly"? I am an Appeals Nurse for outpatient claims that are reviewed by Cahaba. I have never received an appeal for a urine culture that has been denied for lack of a diagnosis where the provider has requested to add either 780.99 or 799.3 to the claim when the documentation supports this is what they should have coded. Also, nurses and physicians aren't certified coders and this NCD could be a little more "user friendly" for all health providers. Thanks alot!!!

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as a coder, we will have cultures denied. I suspect other hospitals like ours has a protocol for the lab. If there are so many white, red, bacteria, ect, they automatically do a culture. The culture may grow something that is then treated, however, the patient may not be able to convey any symptoms that will provide coverage. (we have a nursing home). I also thought that if the culture was positive and a uti was diagnosed, that we could not use this dx since it was after the fact, not the reason for the culture. I think a clarification of these issues would be good.

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