Laureen shows you her proprietary “Bubbling and Highlighting Technique”
Download your Free copy of my "Medical Coding From Home Ebook" at the top right corner of this page
Specificity will help your inpatient rehab facility meet the 60 percent rule. The opioid crisis has drawn a lot of attention to the number of people who suffer from pain. It’s important to understand that there are different kinds of pain. Pain should be accurately categorized and coded with specificity, especially in the inpatient rehabilitation […]
The post Ease Central Pain Syndrome Coding in the IRF appeared first on AAPC Knowledge Center.
D61.01 Constitutional (pure) red blood cell aplasia (Blackfan-Diamond)
D70.4 Cyclic neutropenia
Q45.3 Other congenital malformations of pancreas and pancreatic duct
Thanks for your help!
Liz
About the patient, his final diagnosis is post-concussion with profound cognitive impairment (MOCA 11/30) but I am not sure MD documentation supports it. His documentation does not mention any head injury but he was in a MVA 4 months ago. So the main complaint is confusion and worsening memory loss. I don’t see any mention of headache, dizziness or the typical 3+ symptoms you would see with PCS. He does state some worsening hearing loss but doesn’t tie that to MVA.
We did discuss this further with the provider (Neurologist) and he explained he didn’t have to hit his head to have a head injury. The provider went back in and added S09.90XS which I also don’t agree with since he didn’t mention a head injury. So my question is ‘do we code with F code on its own, with the undocumented Head injury, or cognitive impairment/memory loss.
Can also use some additional educational materials if anyone know where I find them.
Thank you Joan Horner
I have found the below documentation from the 2010 ICD-9 Coding Clinic that states if a pacemaker is placed to treat the sick sinus syndrome, that only the pacemaker code should be used. I am not able to find any documentation that shows this has changed. Would this only occur during the interrogation? Would you be able to bill both codes out at a regular follow-up visit?
Would a complete heart block fall into the same situation? I am not able to find any official documentation to confirm if the complete heart block and pacemaker codes can be used together.
Not billing the complete heart block would affect the patient’s risk score just as with the sick sinus syndrome.
Any and all help is greatly appreciated!
Thank you – Missy
ICD-9-CM Coding Clinic, Third Quarter 2010 Pages: 9-10 Effective with discharges: October 1, 2010
Question:
Coding Clinic, Fifth Issue 1993, page 12, advised that when sick sinus syndrome (SSS) is controlled by a pacemaker, no code assignment is required if no attention or treatment is provided to the condition or the device. However, we are seeing records where the patient is admitted for an unrelated condition, but during the stay the physician does an interrogation of the pacemaker. Is it appropriate to assign a code for sick sinus syndrome, as a chronic condition, when a patient has a previously placed pacemaker and it is interrogated during the hospitalization?
Answer:
Assign code V53.31, Fitting and adjustment of other device, Cardiac device, cardiac pacemaker, as an additional code assignment. A code is not assigned for sick sinus syndrome when it is being controlled by the pacemaker and no problems are detected during the check. Interrogation is a routine check, which is done via computer to assess pacemaker function. The pacemaker is routinely evaluated to ensure the device is programmed accurately as well as to assess battery and lead function. Pacemaker settings may be reprogrammed, if required. Interrogation of the device can be done in the inpatient setting or in the office setting.
Code 89.45, Artificial pacemaker rate check, may be assigned for the procedure.
I appreciate the help! I’ve spent 30 minutes trying to figure this out.
Thank you in advance!