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ICD-9 code for PANDAS


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I'm looking at a recent superbill and there is an ICD-9 for unspecified psychosis on it.

PANDAS is written at the bottom with no ICD-9 next to it.

This is paperwork for submission to insurance for reimbursement.

 

Is this a typical ICD-9 for a kid with PANDAS?

 

Tics are the reason for the doctor visit.

 

Please share your thoughts.

 

Thanks

Dave

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I am still looking, but so far this is what I have found:

 

Obsessive-compulsive disorder

 

Definition

 

The essential feature is recurrent obsessional thoughts or compulsive acts. Obsessional thoughts are ideas, images, or impulses that enter the patient's mind again and again in a stereotyped form. They are almost invariably distressing and the patient often tries, unsuccessfully, to resist them. They are, however, recognized as his or her own thoughts, even though they are involuntary and often repugnant. Compulsive acts or rituals are stereotyped behaviours that are repeated again and again. They are not inherently enjoyable, nor do they result in the completion of inherently useful tasks. Their function is to prevent some objectively unlikely event, often involving harm to or caused by the patient, which he or she fears might otherwise occur. Usually, this behaviour is recognized by the patient as pointless or ineffectual and repeated attempts are made to resist. Anxiety is almost invariably present. If compulsive acts are resisted the anxiety gets worse.

 

Incl.:

anankastic neurosis

obsessive-compulsive neurosis

 

Excl.:

obsessive-compulsive personality (disorder) (F60.5)

 

F42.0 Predominantly obsessional thoughts or ruminations

 

Definition

 

These may take the form of ideas, mental images, or impulses to act, which are nearly always distressing to the subject. Sometimes the ideas are an indecisive, endless consideration of alternatives, associated with an inability to make trivial but necessary decisions in day-to-day living. The relationship between obsessional ruminations and depression is particularly close and a diagnosis of obsessive-compulsive disorder should be preferred only if ruminations arise or persist in the absence of a depressive episode.

 

F42.1 Predominantly compulsive acts [obsessional rituals]

 

Definition

 

The majority of compulsive acts are concerned with cleaning (particularly handwashing), repeated checking to ensure that a potentially dangerous situation has not been allowed to develop, or orderliness and tidiness. Underlying the overt behaviour is a fear, usually of danger either to or caused by the patient, and the ritual is an ineffectual or symbolic attempt to avert that danger.

 

F42.2 Mixed obsessional thoughts and acts

F42.8 Other obsessive-compulsive disorders

F42.9 Obsessive-compulsive disorder, unspecified

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these are some of the ICD-9 codes we submit on superbills depending on what we see but they do have to be in addition to the most accurate descriptor of their symptoms (tics, anxiety or OCD etc):

 

323.62 Post infectious encephalitis

279.3 Unspecified Immune Deficiency

279.4 Autoimmune otherwise unclassified

348.30 Encephalopathy unspecified

392 Rheumatic chorea

 

Who knows if they help or not??

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