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I am hoping someone can help me on this, through school and all of my experience as an outpatient physician office coder (5yrs), I have been under the impression that we cannot code a diagnosis that was found after testing or procedure. For example, patient has renal disease so doctor orders an echo in office and finds Mitral Regurgitation. I understood the proper coding would be to code the renal disease because we didn't find the MR until after the testing. Well, I was reviewing some of my school books and it states for a physician an outpatient diagnostic test result if found abnormal may be coded with that abnormality, such as the Mitral Reg. Now I am unsure, is this just for testing that we can use a "found" DX? When I have a patient go in for a heart cath and we find CAD and then place a stent, I know we have to code the cath with a DX that was the reason for going to Cath lab, but with the stent because it was done after we found CAD, we could then code the stent with CAD. Hope this makes sense, bottom line, I thought if it was inpatient we can use DX found before, after, rule out, and so on, but with outpatient it had to be an existing code. Any help is appreciated!!! Gail