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Thread: inpatient diagnosing question

  1. #1

    Default inpatient diagnosing question

    AAPC: Back to School
    I have read that in the inpatient setting, a condition reported as probable, suspected, likely, questionable, possible, still to be ruled out, or other similar terms indicating uncertainty, is coded as if it existed or was established. Any thoughts? Is this true?

  2. #2


    Yes, that is true for inpatient.

  3. #3
    Join Date
    Apr 2007
    Dover Seacoast New Hampshire


    It is true that inpatient coding allows you to code based on 'suspected', 'rule out', etc. This is for those coding for the facility.....where the coder would abstract the list of diagnosis codes to report the total DRG....not to be confused with physician or other professional services performed in the inpatient setting. For inpatient professional fee services, you must code the definitive diagnosis, and if reported as 'suspected', etc., code the symptoms.
    Pam Brooks, MHA, CPC, PCS, COC
    Coding Manager
    Wentworth-Douglass Hospital
    Dover, NH 03820

    If you can dream it, you can do it. Walt Disney

  4. #4
    Join Date
    Apr 2007
    Bangor, Maine


    Yes, this is definitely true!! This is a very specific rule to coding!
    Make sure to read the coding guidelines in the front of your ICD-9 coding book! The ones that are printed in the coding books are always a year or so behind because they go to print so early, but you can always find a current version online through the AMA or other websites. You should always, always code according to your coding guidelines.

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