Wiki Pathology Report Discrepancy, help needed please.

[willblanding@gmail.com]

Dear all, could you please advise the below question?
Patient admitted to the Outpatient hospital with planned cholecystectomy for the complaint of chronic mild cholecystitis and sent the gall bladder to the pathology. Pathology report shows acute on chronic cholecystitis. Shall we:
A. Code only Chronic cholecystitis-K81.1 and disagree with pathology report. Or
B. Code Acute on chronic Cholecystitis -K81.2, Agree with pathology report

Please advise, thank you so much!

 

[Pam Warren]

You would code from the pathology report only if the surgeon notes its clinical significance.

 

[willblanding@gmail.com]

Well noted...thank you so much Pam, much appreciated. : )