Wiki Diagnosis

[Murugapandiyan]

can anyone suggest me If a probable condition is being treated, would we be coded for that condition?

 

[balamuruganm]

Hi

if the document support ''probable condition is being treated'' and the final diagnosis is same condition documented then you can code other wise don't code

 

[mitchellde]

can anyone suggest me If a probable condition is being treated, would we be coded for that condition?

In the coding guidelines it states that you cannot code uncertain diagnosis (possible, probable, suspected, rule out, consistent with) if you are coding for the physician or outpatient facility. However if you are coding for inpatient facility coding then you do code the uncertain diagnosis as though it exists. If the provider documents the condition as probably and begins treatment for that condition, you can code only the symptoms. Be aware that some treatments procedures may not be paid using the symptoms, but you have no other choice when coding for the provider.

 

[midnightsun1369]

? to Debra:

I bill for docs who see pt in hospital setting. Claim is billed as professional. Should I be coding the uncertain diagnoses as if they exist?

Thank you.

 

[mhstrauss]

? to Debra:

I bill for docs who see pt in hospital setting. Claim is billed as professional. Should I be coding the uncertain diagnoses as if they exist?

Thank you.

No. Even though the service is taking place in an inpatient setting, you still have to follow the guidelines for coding for a physician...which cannot use probable, possible, etc.

 

[mitchellde]

? to Debra:

I bill for docs who see pt in hospital setting. Claim is billed as professional. Should I be coding the uncertain diagnoses as if they exist?

Thank you.

No you are coding for the physician so it does not matter the setting, physician rules will apply, which means you can never code an uncertain diagnosis. The facility coder however will code the uncertainty as though it exists.