Question LTAC and covid-19

jemanthey

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I am doing pre-admission coding and I am trying to do pre-admission for patients previously hospitalized for covid-19 and associated conditions. Since it affects DRG values my question is how long after a positive covid-19 test are they assumed to have covid-19? A lot of times they are not retested to see if they are negative. Is a negative test required to no longer consider it a primary admission diagnosis?
 

thomas7331

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I'm not aware of any guidelines that allow a coder to assume the diagnosis is active for any given period of time - my understanding is that it is a clinical decision that has to be made by the provider. My organization has instructed us to code the active COVID-19 diagnosis any time there is a positive test result in the record of that same encounter, but for positive results from tests done prior to admission we would be required to rely on the provider to document whether the patient's condition was active or resolved at the time of admission, or query them if the status of the diagnosis is not clear.
 

jemanthey

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I'm not aware of any guidelines that allow a coder to assume the diagnosis is active for any given period of time - my understanding is that it is a clinical decision that has to be made by the provider. My organization has instructed us to code the active COVID-19 diagnosis any time there is a positive test result in the record of that same encounter, but for positive results from tests done prior to admission we would be required to rely on the provider to document whether the patient's condition was active or resolved at the time of admission, or query them if the status of the diagnosis is not clear.
Thank you for your response. It reaffirms what I was already doing but I'm trying to maximize the reimbursement level so I wanted to make sure.
 
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