Using Additional Codes with Chapter 16 Codes

morris-jeff@CooperHealth.edumorris-jeff@CooperHealth.edu
in Pediatrics

Good Afternoon,

We recently had an infant with oral candidiasis that was coded as P37.5 (neonatal candidiasis). Well, our outside auditor suggested the addition of code B37.0 for oral candidiasis stating that the ICD-10 Official Guidelines Chapter 16 a 3 state that additional codes from other chapters may be used with codes from chapter 16 when those codes provide greater specificity.

My issue is that B37.0 has an Excludes 1 note for P37.5

So, is it appropriate to add the B37.0 when it has an Excludes 1 note? Since the guidelines state that additional codes may be used, is it ok to ignore the Excludes 1 note (I'm thinking not)? Does it add greater specificity yes, but it also increases reimbursement so I want to make sure that we are being advised properly as this record could come up in an audit.

Thanks,

Jeff

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