Fungal Sinusitis: 2 Guaranteed Medical Coding Formulas That Work

The two areas you must focus on should be manifestation and kind of fungus.

Though unusual, some sinus infections are caused by fungus. When the otolaryngologist makes a diagnosis that a patient is infected with fungal sinusitis, a lone code will not be your easy way out. Read this article and learn from the experts what ICD-9 codes you must select in such a case for accurate medical coding.

In its place, you should depend on a grouping of ICD-9 codes, and a careful examination of the physician's notes for manifestations.

Scenario: A patient visits and reports to the office with the complain of severe headaches, loss of appetite as well as postnasal discharge into the throat. An ENT then diagnoses the patient with fungal sinusitis confirmed on culture. She then also writes down that a chronic ethmoidal kind of sinusitis owing to aspergillosis troubles the patient.

In case you check the ICD-9 codes manual for a code for fungal sinusitis, you would be directed to 117.9 (Other and unspecified mycoses). However a single code may not correctly describe the patient's condition. Here's what you should do:

1. List Manifestation As Primary Diagnosis

The first instruction for category 110-118 (Mycoses) directs you to use added code to classify manifestation. Mycoses pertain to any disease caused by fungi. In the scenario specified above, the ENT classifies the fungi as aspergillosis, and further the condition as chronic ethmoidal sinusitis. The specific fungi will not be identified until a culture is taken and sent to pathology for identification. You would use 117.9 while waiting for the definite fungi to be identified.

When you have this information, then you must go on by reporting the appropriate sinusitis code for sinus membrane lining inflammation. As far as chronic sinusitis is concerned, you would report 473.x, choosing the fifth-digit code based on where the sinusitis takes place. Keep in mind that you should pick the code 461.x for acute sinusitis.

In case of ethmoidal chronic sinusitis, you must report ICD-9 code 473.2 (Chronic sinusitis; ethmoidal). This is a situation that attacks the ethmoid sinuses, which are situated within the human skull between the eye sockets and above the nose.

2. Don't Leave Out Underlying Fungal Infection Code

Once you've coded the manifestation, after that you must report the ICD-9 code that best characterizes the fungal infection. Some types of mycoses consist of dermatophytosis (110), candidiasis (112), as well as blastomycotic infection (116). The fungus aspergillus (117.3, Aspergillosis) is found in compost heaps, air vents or airborne dust. Inhaling it may lead to ethmoidal sinusitis owing to aspergillosis.

On your claim, you must write down 117.3 as diagnosis 1 and 473.2 as diagnosis 2, specifically in Box 21 of the CMS-1500 form.

ICD-9 Quick fact: The condition produced by fungus aspergillus is generally marked by inflammatory granulomatous lesions in the skin, ear, orbit, nasal sinuses, lungs, and occasionally in the bones and meninges.

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