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JustCoding News: Inpatient, August 1, 2012

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I was auditing a chart and ended up having to downgrade a DRG. Patient was admitted with ischemic colitis. Blood cultures were taken in the ED. Patient was started on antibiotics. Patient did not have fever, wasn't hypotensive, tachy. Two days into the stay the patient's blood cultures came back + with gram - bacteria in both bottles. From then on the physician documented sepsis for the rest of the stay.

The coder coded the ischemis colitis as the principal diagnosis. I believe that the sepsis should go first especially since this is a systemic infection vs. a localized process. Patient ended having a left hemicolectomy. Thoughts on this please.

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