Pulmonology Coding Alert

Advise: Consider alternate diagnoses until the patient's condition is accurate.Coding ventilator-associated pneumonia (VAP) offers more grey area that what you'd expect. In fact, not all cases of ventilated patient with pneumonia call for 997.31. Avoid a potential audit by making the need for the diagnosis less frequent. Here are some key points to look into for VAP-coding guidance.Overzealousness Spoils 997.31 DiagnosisWhile many physicians treating pneumonia for a patient on a ventilator would simply code the diagnosis as VAP (997.31), this practice is simply off the mark. Often, pulmonologists do not order a chest xray or a culture when trying to diagnose VAP. This makes getting an accurate diagnosis more difficult. Don't be too quick to report 997.31 only because the patient is ventilated, and is showing signs of pneumonia.First, you should consider the patient's history and possible alternate diagnoses, such as heart failure (428.9), hemoptysis (786.3), acute respiratory distress syndrome [...]