How to code a tick bite ?

A patient presents to the clinic with tick bite and the tick still present into the skin. The physician examines the injury and removes the tick with a forcep. What are the diagnosis and procedure codes we would use for this visit?

Tick bite is a non-venomous insect bite and is coded to injury --> Superficial by site (Plus the 4th digit as 4 or 5 as necessary depending upon if there is an associated infection at the site of injury ); and an E code which will always be E906.4 for tick bite.

For example tick bite one the face with removal of tick with a forceps will have following codes:
911.4      Tick bite of face
E906.4    E Code for Tick bite
98.22      Nonoperative removal of foreign body from skin of head and neck 
E/M code

Providers usually removes the tick with a forcep and/or any other method which would not require an incision into the skin. Hence CPT codes for the procedure are not required as removal of foreign body from skin without incision is included in E/M as per CPT guidelines. We can assign ICD procedure code 98.2x for removal of foreign body from the skin without incision depending upon the anatomic site of the injury.

The site of tick bite can get infected and the provider may sometimes document the diagnoses of cellulitis along with the tick bite. In such cases, two codes are required to code the visit completely. One code for tick bite infected and another code for the infection which will be cellulitis in this case. Also the selection of principal diagnosis would depend upon the reason for visit.

In rare situations where the physician removes the foreign body with an incision into the skin, CPT 10120 along with an E/M code with modifier 25 can be coded.  

Some coders confuse tick bite with 989.5(tick paralysis) which is a different condition and not relevant at this visit.

1 comment:

Vijay Chaudhary said...

The following information on below link is incorrect, 911.4 is for Trunk, not for face. For face, it should be 910.4

http://medical-coding-carers.blogspot.in/2012/11/how-to-code-tick-bite.html

For example tick bite one the face with removal of tick with a forceps will have following codes:
911.4 Tick bite of face

Related Posts with Thumbnails