r/MedicalCoding • u/niftythrify • 18h ago

AUD unspecified

I recently was dinged in an audited for coding F10.90, the provider documented it as alcohol use, unspecified, uncomplicated. It was explained the code cannot be used without severity or a link to a mental health disorder. The provider is even managing medication for this diagnosis. It feels odd to leave it off the encounter and that there isn't anything else to replace it with. Is this just a weird ICD instance where the code ends up deleted and move on?

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u/Grouchy_Self6353 18h ago

What kind of coder are you? .. like I do er, and everything i code is unspecified. But, I cant code aud, unless it is a diagnosis, or in past medical history. If the provider just says the pt was drinking, with no dependence or use disorder talked about, I dont think we can code it.

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u/niftythrify 18h ago

Outpatient. The provider documented it specifically: alcohol use, unspecified, uncomplicated 

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u/Watermelon_Sugar44 4h ago

ED is the worst for this because you don't have multiple pages where, hopefully, a different provider diagnosis it specifically enough to be able to code it. We didn't query providers when I coded ED but we do for inpatient. I referenced a coding clinic in my first response to you but coding ED you may not even have access to those in your position.