ED Coding and Reimbursement Alert

Question: I know all about avoiding the coding of diagnoses using probable, suspected, and other similar terminology, but what about the term “correlation”? For instance, if a provider says findings on a computed tomographic angiography (CTA) are “correlated” with aortic valve stenosis, does that meet the criteria for reporting it?

Arizona Subscriber

Answer: You already know you won’t find any guidance on this specific term within the ICD-10-CM guidelines. However, you should consider a widely known rule within the world of statistics to base your answer upon: “Correlation does not equal causation.” The idea similarly applies when you’re “correlating” a set of findings to a particular diagnosis. While the physician might consider the findings conclusive, the phrasing of the dictation report does not allow you to code it as such.

In these instances, it’s best to reach out to the provider to confirm whether they believe the diagnosis is definitive, or if there’s simply a strong likelihood of aortic valve stenosis based on the findings within the CTA. As the dictation report currently stands, you should code based on the signs and symptoms unless you hear otherwise from the provider.