Internal Medicine Coding Alert
You Be the Coder:
Which Conditions Get Priority?
Published on Fri Sep 24, 2004 
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Question: Our physicians are treating a patient's respiratory insufficiency. They think that the patient's COPD caused this condition. Which diagnosis should we code first?
Illinois Subscriber
Answer: Correct coding requires that you list the primary diagnosis first, according to the American Medical Association's guidelines. For instance, the physician's notes read respiratory insufficiency (786.09, Symptoms involving respiratory system and other chest symptoms; dyspnea and respiratory abnormalities; other) secondary to chronic obstructive pulmonary disorder (COPD) (496, Chronic airway obstruction, not elsewhere classified). This means COPD is the primary condition, and you should list it first.
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