Do 569.3 And 578.1 Function The Same Way?

By Author: erinarticle
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As a just-in gastroenterologist coder, sometimes you may run into rough weather or be confused about which code to use for a particular service.


For instance, a just-in coder was confused about when to use 569.3 and 578.1 for bloody stool? She was trying to figure out if they are one and the same.


Well, the answer is no. When you examine the stool, you would be able to decide on the original source of the bleeding. After that you would be able to select the proper ICD-9 code.


Blood in the stool originates from somewhere up the gastrointestinal tract. In this situation, you would use 578.1 (Blood in stool). On the contrary, traces of bright red blood on the outside of the stool or on the toilet tissue normally takes place from a source within the rectum or anus (569.3, Hemorrhage of rectum and anus).


While coding for a colonoscopy (45378), you would normally report 578.1 with 792.1 (Nonspecific abnormal findings in stool contents). A number of carriers do not accept rectal bleeding as a justifiable diagnosis for colonoscopy as they presume that the ...
... source of the bleeding is the rectum or anus, not the colon. But then, they accept rectal bleeding as an acceptable diagnosis for a flexible sigmoidoscopy (45330, Sigmoidoscopy, flexible; diagnostic, with or with no collection of specimen[s] by brushing or washing [separate procedure]).


Here's a hint: The gastroenterologist would opt for a colonoscopy if the flexible sigmoidoscopy does not reveal a source of the bleeding. The source could lie past the splenic flexure, which is only visible through a colonoscopy.


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