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Thread: Admitting diagnosis, outpatient

  1. #1
    Join Date
    Apr 2007
    Milwaukee WI

    Default Diagnosis is NOT same as chief complaint

    AAPC: Back to School
    The chief complaint is the problem bringing the patient to the healthcare provider - in the patient's own words.

    The diagnosis is arrived at by the provider after examining the patient and reviewing the history.

    Chief complaint - sore on butt
    Diagnosis - abcess on buttock, probably MRSA infection
    (of course you wouldn't be able to code the "probable" but that's how I see them written all the time).

    Chief complaint - fell off swings, hurt wrist
    Diagnosis - Right distal radius fracture

    Hope that helps.

    F Tessa Bartels, CPC, CEMC
    Last edited by FTessaBartels; 03-11-2010 at 01:33 PM.

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