Wiki feb newsletter question

[diann]

We are having a discussion (since I have a new coder in my group) about the Hypertension & CKD coding and the February Magazine came at just the right time! We know if the provider does not specifically state that the CKD is not related to the HTN then we are to assume that there is the casual effect and to code as such...but (and here is the question prompted by my new coder!) If we get a lab requisition and that provider office has listed I10, E78.5, N18.30, D63.1 as the diagnosis, are we to assume that the provider is stating that there is no casual relationship? Her argument is that ... most times it is office staff, nurses, etc filling out the lab requisition and not the provider? What will an auditor say if they see that lab requisition and if the coder uses I12.9 and N18.30?

 

[LisaAlonso23]

We are having a discussion (since I have a new coder in my group) about the Hypertension & CKD coding and the February Magazine came at just the right time! We know if the provider does not specifically state that the CKD is not related to the HTN then we are to assume that there is the casual effect and to code as such...but (and here is the question prompted by my new coder!) If we get a lab requisition and that provider office has listed I10, E78.5, N18.30, D63.1 as the diagnosis, are we to assume that the provider is stating that there is no casual relationship? Her argument is that ... most times it is office staff, nurses, etc filling out the lab requisition and not the provider? What will an auditor say if they see that lab requisition and if the coder uses I12.9 and N18.30?

I would not rely on the provider's codes, as he/she most likely does not code per the ICD-10 guidelines. In this situation, I would query the provider and request that future lab requisitions have the diagnoses written out.

 

[diann]

I would not rely on the provider's codes, as he/she most likely does not code per the ICD-10 guidelines. In this situation, I would query the provider and request that future lab requisitions have the diagnoses written out.

That sounds like good idea. We are in an hospital setting and luckily there is only a few providers faxing us these type of requisitions.