Health Information Management

Q&A: Coding for poisoning due to bath salts

JustCoding News: Inpatient, August 1, 2012

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QUESTION: I'd like to address our coders' questions on how to code poisoning due to
bath salts. Internet research has led me to many different options: codes 977.8 (other specified drug/medicinal), 970.89 (other CNS stimulant), 969.70 (psychostimulant, unspecified), among others. What would you suggest? There don't seem to be any guidelines out there and the coding for this seems to be all over the place.
 

ANSWER: Bath salts are not referenced on the ICD-9-CM Manual’s Table of Drugs & Chemicals, which would solve the problem. So what are bath salts? When I think bath salts, I think about the salts you pour into your bathtub that have a calming, relaxing, and sometimes homeopathic effect. So, I did an Internet search and was shocked to find that this is actually a drug problem that seems to be very common. (Here is a link to just one of the articles I read.) It sounds as if experts are calling bath salts synthetic cannabinoids and people are actually taking the bath salts for their hallucinogenic properties. 
 
I can see justification for code 977.8. I don’t agree with either code 970.89 or 969.70. If anything, it would be code 969.79 (other specified). However, since bath salts are actually synthetic cannabinoids and also people are using them for their hallucinogenic properties, I would think code 969.6 (psychodysleptics [hallucinogens]—cannabis [derivatives]) would be the most appropriate choice. Without further guidance, however, this is up for debate and it is a good question to pose to AHA Coding Clinic for a decision. 
 
Editor’s Note: Jennifer Avery, CCS, CPC-H, CPC, CPC-I, regulatory specialist for HCPro, Inc., in Danvers, Mass., answered this question.
 
This answer was provided based on limited information that was submitted to JustCoding.com. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.
 
Need expert coding advice? Submit your question to Senior Managing Editor Andrea Kraynak, CPC, at akraynak@hcpro.com, and we’ll do our best to get an answer for you.



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