Wiki Help with Principle Dx Code- inpatient stay

sigmathree137

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Local Chapter Officer
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Pomona, NY
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Hi everyone,

We are having a debate between our internal coders and outside consultant regarding a DRG assignment.

Patient is a neo-nate born with severely low birth weight (350 grams). The primary ICD-10 code assigned by the original hospital was P07.01.

The patient was then transferred to our hospital for more acute care, but at this point weighed 2965 grams at the time of admission. The child had severe co-morbidities associated with the low birth weight (i.e. GI tube etc.).

We believe that this should continue to be the primary diagnosis code, as the child was still under care for their low birth weight. The guidelines state that POA should be coded for "newborns with conditions present at birth or in utero." Also, ICD-10 coding guidelines state in section 16.4 "should a condition originate in the perinatal period, and continue though out the life of the patient, the perinatal code should continue to be used regardless of the patient's age." Section 16.6 also states "the perinatal guidelines listed above are the same as the as the general coding guidelines for 'additional diagnoses.' except for the final point regarding implications for future health needs. Codes should be assigned for conditions that have been specified by the provider as having implications for further health needs."

Should the primary Dx code remain P07.01 OR be reassigned to one of the co-morbid conditions?
 
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