cpccoder2008
True Blue
I am one of the inpatient coders for my local hospital and we are having a debate on whether or not you can use Versus diagnosis. Example,, we have a 1 year old who came in with fever and thigh/ leg pain. The thigh is swollen and very hard to touch. Our ortho doctor was consulted and ordered a MRI but we are unable to perform it at our hospital so the patient was transferred to a childrens hospital near by. The patient was admitted for one day before being transferred. On the discharge summary the final diagnosis is R/O deep abcess, R/O osteomylelits vs Septic Joint vs Pyomyositis. I can query the physician as we have done many times before but since the patient was only in house for one day chances are the doctor was never able to come to a final diagnosis which is why they put Versus. My question is how do we code this chart ? Do we pick the higher DRG since inpatient guidleines state that if a diagnosis is suspected you treat it as if it exsisted or do we pick the signs and symptoms ? I say we should pick the higher DRG since the physician treated the patient for all diagnosis and at the time of discharge was still unable to determine the appropriate one, however, my co worker disagree's and feels we should only code the signs and symptoms because the inpatient coding guidelines is no clear on how to code Versus it only talks about suspected diagnosis. Any feedback would be appreciated.
thanks
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