Dx "rule out cardio-embolic source"?

kshell73

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Hey all And Happy New year!

Im new to cardiology, my Dr is doing a lot of Echos in the hospital for patients who have had a TIA to rule out a cardiac embolism. The TIA is a non compatable dx for the echo and the "rule out" scenario doesnt seem to be an option either. Im finding no other suitable dx in the dictation... does anyone know something about dx coding for the "rule out" term?
Thanks-

Kim:confused:
 
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mitchellde

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When coding for the physician you canot code Rule out, you can only code the symptoms that prompted the test or the diagnosis after study.
 

kshell73

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Yes, and this is my delemia! I have explained this to him,but he states the testing has to be done to rule out the scenario. I was asking if there is a DX code out there for such scenarios, Ive only been in the cardiology office 1 month but Im seeing this a lot.
 

mitchellde

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The the patient had a TIA and for some reason he feels a cardiac embolism is the cause? How far out of the acute TIA is this being performed? If it is during the same episode then what you have is the TIA dx if after the acute event then you have a hx of a TIA, you will need a V code. If the echo shows an embolism then use that for your dx if the echo is normal then you code a V71.7 9 (FIRST-LISTED ONLY)for condition suspected but not found plus a 435.9 or a V12.54, there is nothing else you can code. If this is a Medicare patient and you did not obtain an ABN prior to the procedure then you cannot bill the patient.
 
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