BC Advantage - 2017 Issue 11
Pica The Need to Eat Dirt and Other Non-Food Stuff
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Article Overview
This article provides a clinical overview of pica and then shifts into coding and coverage considerations for related diagnosis reporting and outpatient services. It is useful for coders, billers, clinicians, and revenue cycle staff who need a broad understanding of the condition, associated evaluation and management themes, and the insurance context discussed in the article.
Why This Topic Matters
Pica can affect children, adults, and pregnant patients, and it may be associated with nutritional deficiencies, mental health conditions, complications, and lab testing needs. The article helps readers understand the condition at a high level while also identifying the coding and coverage topics that may be relevant to documentation and reimbursement workflows.
Article Sections
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Etiology
Discusses general causes and associations that may be linked to the condition across different patient groups. Includes broad discussion of nutritional, developmental, cultural, and mental health factors.
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Diagnosis
Summarizes the clinical evaluation process and the kinds of findings or assessments that may be considered when the condition is suspected. Also outlines broad diagnostic criteria and special considerations for pregnancy.
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Treatment
Covers general management approaches, including monitoring and mental health support. Mentions behavioral and medication-based strategies at a high level.
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Complications Associated with Pica
Reviews broad categories of medical complications that can occur when nonfood items are ingested. Focuses on general risks such as toxicity, deficiency, obstruction, injury, and infection.
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Blood Work and Lab Tests
Lists general categories of laboratory and related follow-up testing that may be performed after diagnosis. Emphasizes monitoring rather than specific interpretation.
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Prognosis
Provides a high-level overview of expected duration and differences in course across patient populations.
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ICD-10-CM Coding
Presents diagnosis coding examples related to pica and distinguishes between different patient scenarios. Serves as a bridge between the clinical discussion and coding application.
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Billing
Discusses coverage and billing considerations for diagnostic testing and therapy-related services. Includes general payer and benefit context without detailing individual plan policies.
What You Will Learn
- What pica is and which patient populations it commonly affects
- Common clinical associations and potential contributing factors
- How pica may be evaluated and monitored at a high level
- What broad complications can be associated with the condition
- Which general laboratory categories may be followed in ongoing care
- How the article connects pica to diagnosis coding and coverage considerations
Who Should Read This
- Medical coders
- Medical billers
- Clinical documentation staff
- Healthcare providers
- Revenue cycle professionals
- Coding students
Codes Discussed
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