Q&A: Complication codes versus condition codes
CDI Strategies, June 11, 2015
Want to receive articles like this one in your inbox? Subscribe to CDI Strategies!
Q: When I started as a CDI specialist, I learned that when a complication code, such as 999 or 998 series, happens to be the reason of admission, along with another condition also contributing to the admission, the complication code takes precedence over the other condition code. Is this correct, and is there any written guidance like an AHA Coding Clinic for ICD-9-CM/ICD-10-CM/PCS that discusses this?
A: First refer to the code set’s alphabetic index and tabular list guidelines related to sequencing, with notes that instruct us to code first or code also. There is instruction within the Official Guidelines of Coding and Reporting as to how to interpret the directional notes found here. For example: “Section I. Conventions, general coding guidelines and chapter specific guidelines.”
Coding Clinic also gives us guidance, however, there is a hierarchy for which piece of guidance supersedes the other. First follow the instruction within the index and tabular list (coding conventions) as these are the highest, followed by the Official Guidelines of Coding and Reporting, and lastly the Coding Clinic advice.
Complications of surgery and other medical care. When the admission is for treatment of a complication resulting from surgery or other medical care, the complication code is sequenced as the principal diagnosis. If the complication is classified to the T80-T88 series and the code lacks the necessary specificity in describing the complication, an additional code for the specific complication should be assigned. Thus, your understanding of how these should be sequenced is absolutely correct, and now you are able to state where you accessed this instruction. Editor’s Note: Laurie L. Prescott, RN, MSN, CCDS, CDIP, AHIMA Approved ICD-10-CM/PCS Trainer, and CDI Education Specialist at HCPro in Danvers, Massachusetts, answered this question. Contact her at lprescott@hcpro.com. For information regarding CDI Boot Camps visit www.hcprobootcamps.com/courses/10040/overview.
Want to receive articles like this one in your inbox? Subscribe to CDI Strategies!
Related Products
Most Popular
- Articles
-
- Math can be tricky: TJC corrects ABHR storage requirement
- Air control equals infection control
- Don't forget the three checks in medication administration
- Note similarities and differences between HCPCS, CPT® codes
- Residency coordinators’ responsibilities
- The consequences of an incomplete medical record
- Practice the six rights of medication administration
- Study: Shorter shifts reduces residents’ attentional failures
- OB services: Coding inside and outside of the package
- Five ways to safeguard your patients' valuables
- E-mailed
-
- OSHA HazCom updates include labeling, SDS requirements
- Air control equals infection control
- Q&A: Are colleges sending students to our facility for rotations business associates?
- Patient classification systems to coordinate patient care
- Nursing's growing role
- Note similarities and differences between HCPCS, CPT® codes
- Note from the instructor: CMS clarifies billing guidelines on proper billing for drugs in a single-dose or single-use vial, including billing for discarded drugs
- Fracture coding in ICD-10-CM requires greater specificity
- Five ways to safeguard your patients' valuables
- Differentiate between types of wound debridement
- Searched