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Manifestation Codes

Hi-

I have a chart where the px has been diagnosed with Lewy Body Dementia. I coded it with the G31.83 code followed by the F02.80 code. The documentation does not state whether or not the condition exist with or without behavioral disturbance and I cannot query the provider. So my auditor asked that I remove the F02.80 code. I thought this code is mandatory if it is in brackets. She says it only applies "if applicable" And since I don’t knowif the px has a behavioral disturbance or not, I have to remove the F02.80 code.

Can someone weigh in on this and let me know if my interpretation is correct? Or if my auditors interpretation is correct.

Medical Billing and Coding Forum – Diagnosis Coding