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ICD-9 code for PANDAS

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#1 problemsolver


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Posted 14 January 2012 - 12:46 AM

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.


#2 bulldog24


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Posted 14 January 2012 - 02:16 AM

I believe there is no code for pandas

#3 powpow


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Posted 14 January 2012 - 03:28 AM

pm'd you

#4 mayzoo


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Posted 15 January 2012 - 10:43 AM

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

Obsessive-compulsive disorder


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.

anankastic neurosis
obsessive-compulsive neurosis

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

F42.0 Predominantly obsessional thoughts or ruminations


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]


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

DD (AKA Kiddo :) ) Born 2002. Dxs-PANDAS, Hypogammaglobulinemia, EBV, HHV-6, High Coxsackie b4, b6, A7, A9, A16, A24; Autism. Retrospectively, she has likely had PANDAS since 4-5 yrs old. Very successful T & A 02-2013--cultured actinomyces bacteria.


Started Stephen Buhner's herbal antiviral protocol for EBV on 05-05-2014.  I am expecting a trial of 4-6 months and full therapy to be about year, with years of immune modulation after viruses are under control.


UPDATE: Five months into Buhner's EBV protocol, HHV-6 number is less than half (from 10.71 to 4.54) what it was and all Coxsackie A viruses are now showing IGM negative.  EBV is still > than 600, but in kiddos case I suspect it was VERY high, so it may be going down as well and just not below 600 yet.

#5 amyjoy


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Posted 15 January 2012 - 04:11 PM

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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