Posted by Thomas Marlowe on January 01, 2001 at 09:27:18:In Reply to: billing for restless leg syndrome posted by Jennifer Spiro on April 14, 2000 at 07:59:34:
If I make the diagnosis based on the history (example: I had a patient who came in with fibromyalgia, so I asked her screening questions for migraines, restless-legs syndrome, irritable bowel syndrome, TMJ, bruxism) just write "333.99" at the top of the billing sheet, which goes off to the insurance companies. That's the code listed in the 1999-2000 ICD-9 coding book.
With the patient above, I didn't need any sleep study; history alone was sufficient. I'm not sure I would disagree with an insurance company if they turned down a sleep study ordered for the reason of "restless legs syndrome", which is a clinical diagnosis.
With a different patient, if the diagnosis is not so clear, you are supposed to write the code for the patient's complaint. In other words, if I didn't know whether the patient had RLS or not and they were complaining of leg pain, I might use the code for "leg cramps" on the lab-billing sheet (when I check a potassium level). Or, if they had insomnia and twitched about at night, but wouldn't give a clear history of RLS, I would use the code for "insomnia".
-TSM