Re: Please let me know the diagnosis codes for the following:

[Steve Verno]

it also labels you as a pain in the rump   

[Danni R.]

Thats the magical answer unless you're doign emergency coding. The guidelines do not take ED coding into consideration.  But under normal circumstances, you follow the guidelines.

I think it's great that you pushed him, and AWESOME that he did it!!!! I bet he's all smiles now. Of course, I, too, learned something: persistence pays off.

[Steve Verno]

Thats the magical answer unless you're doign emergency coding. The guidelines do not take ED coding into consideration.  But under normal circumstances, you follow the guidelines.

[Danni R.]

Kudos, Peter... Charlene says, you did it.

       

[Pay_My_Claims]

According to the research i have done so far, we cannot report a separate diagnosis code for a symptom if it is related to the diagnosis.Now you people tell me whether i have reached at a convincing conclusion or not.

You got it Peter!

[Danni R.]

Thank you Danni!
at last some one agreed to what i am trying say........

Not that I agree, Peter. I think a better word is "empathize". I am just as stumped as you are, but YOU have the advantage of being a medical coder/biller, which I am not. However, Steve got me real curious as to what the icd-9 guidelines in the manual say. If he says, it's there, you can bet, it's there.

 I'll have to take a look.

[Danni R.]

your logic is sound, but, if peter goes to the icd-9 guidelines in the manual, he won't be confused regarding coding symptoms.  I can give the answer but it doesn't accomplish anything.  Peter learns when he looks for himself.

When I used to teach CPR, I would have nurses and paramedics try to tell me how they would do it. The hands on test is not a tell me how you do it test, the hands on test means I want them to do it.  

I know Peter isn't questioning my knowledge.  I know the answer.  How?  I RTFM.  I get 10-15 emails a day asking me to code a visit.  If I give the person the answer, what am I accomplishing?  Nothing.  The person will keep coming back for answers!  When forcing them to learn on their own, they become the expert.    

Where did it get Biff when having George do his homework for him.  A life of waxing cars.  

Oh, I think I know!!!! Isn't that "Back to the Future?".

I am with you, Steve! I can't hardly wait until Peter posts the answer!!! I know he  can do it, and when he does, we will all walk with a big smile, including him.

Go, Peter007, go! Go, Peter007, go! Give us the answer.

[Steve Verno]

your logic is sound, but, if peter goes to the icd-9 guidelines in the manual, he won't be confused regarding coding symptoms.  I can give the answer but it doesn't accomplish anything.  Peter learns when he looks for himself.

When I used to teach CPR, I would have nurses and paramedics try to tell me how they would do it. The hands on test is not a tell me how you do it test, the hands on test means I want them to do it.  

I know Peter isn't questioning my knowledge.  I know the answer.  How?  I RTFM.  I get 10-15 emails a day asking me to code a visit.  If I give the person the answer, what am I accomplishing?  Nothing.  The person will keep coming back for answers!  When forcing them to learn on their own, they become the expert.    

Where did it get Biff when having George do his homework for him.  A life of waxing cars.  

[Pay_My_Claims]

Not the gumdrop button!!!

[Danni R.]

hummm..

symptons: cranky, low back pains, vaginal bleeding
DX: Menstrual Cycle
TX: LEAVE HER ALONE!!!

I think I got it!

Ha-ha-ha-ha...

[Pay_My_Claims]

hummm..

symptons: cranky, low back pains, vaginal bleeding
DX: Menstrual Cycle
TX: LEAVE HER ALONE!!!

I think I got it!

[Danni R.]

I admire your way of answering and i dont have any doubt in your knowledge, but i am.........
ok let me explain it in another way. It is not a test question i was just looking at this code and thought of a situation that might occur.
If chart note indicates that patient has ear pain with OM then do we have to use separate dx of ear pain with om or dx code for OM will cover it.

Peter007... my logic is with you! To me, having ear pain with otitis media is logical (and Mr. Spock would agree!).

I wonder myself: Do you really have to indicate ear pain when coding OM? It should be a given. But I am only guessing.

The diagnosis = OM
Symptoms = pain
TX = antibiotics

[Steve Verno]

I only roll over when a good looking lady rubs my belly.  Being an ex-soldier I have a huge bite. 

Peter, we still need to know what the record says.  Thats very important.  Coders code what the doctor documented.  If it aint documented it doesn't exist.

When someone responds with disregard the record when asked about the documentation, that is an indicator they dont have it or the person is asking a test question.  This is from 10 years and 20,000 questions being asked.  I did give you hints where to find the code and where to find the answer to your symptom question. 

Remember, you can say, these arent test questions but we dont know that.

What is in the CC and the definitive diagnosis documented.

Heres a way of thinking:

provider diagnoses patient with definitive dx of otitis media (OM).  The thinking is ear pain is a symptom of OM, so do I code ear pain and Om?  The chart does not document ear pain but ear pain is a symptom of OM.    The ICD guidelines tell us how to code this.  When coding in the emergency department, we go outside the guideline and look at what is documented.   

Again rather that give you the code(s), we want you to learn to do it yourself.  I can say the code is 569.42 but you learn nothing other than to come back and ask for more codes when you need them other that know how to find them yourself.  Plus you dont know if 569.42 is the right answer.

[Danni R.]

Steve is always very harsh in replying.
May be i always ask question in an indecent manner.
My question is that if a person comes to doctor for clostridium difficile and doctor finds that he is also suffering from loss of appetite then what is more appropriate?
to bill only for c difficile or 2 separate icds for this situation.This is not a test this is what i want to know.

That's a good question, I want to know, too.

[Danni R.]

Steve is always very harsh in replying.
May be i always ask question in an indecent manner.
My question is that if a person comes to doctor for clostridium difficile and doctor finds that he is also suffering from loss of appetite then what is more appropriate?
to bill only for c difficile or 2 separate icds for this situation.This is not a test this is what i want to know.

No Peter... you are fine and always welcome. Steven is our gatekeeper and watch dog... no one gets past him, that's his job here. He has the bark of a bulldog, and the bite of a Chihuahua, but if you scratch him between the ears, he'll roll over so you can rub his belly. He's a good guy! I have a feeling you know that.