Wiki Help regardging icd 10 2017 updates

[g01476894]

Can anyone please explain this statement;

"The assignment of a diagnosis code is based on the provider’s diagnostic
statement that the condition exists. The provider’s statement that the
patient has a particular condition is sufficient. Code assignment is not
based on clinical criteria used by the provider to establish the diagnosis."

 

[roy.daman@carolinashealthcare.org]

Can anyone please explain this statement;

"The assignment of a diagnosis code is based on the provider’s diagnostic
statement that the condition exists. The provider’s statement that the
patient has a particular condition is sufficient. Code assignment is not
based on clinical criteria used by the provider to establish the diagnosis."

I am currently taking the CPC course, and the way it was explained to me is that if a provider states that a condition exists, then the methods they use for diagnosis do not have to support it. There is only one exception to this, that I know of, and that refers to immune-compromised patients who are diagnosed with HIV or AIDs.

However, like I said, I am a student so you might want to double-check with an experienced coder.

 

[CodingKing]

It really means you are not a doctor and cannot diagnose a patient. For example if the doctor says the patient has a cold and you think its really the flu based on other information in the medical record that you cannot code it as the flu.