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bundydelly

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Help me refresh my memory! Can we code a diagnosis from psych if the provider is a PhD holder? I'm thinking yes and someone, who is NOT a coder, is telling me no. He's a Doctor of Psychology so that's why I'm leaning yes. I've looked around and can't find a clear answer.

:confused:

Thank you
 
Psychologists are credentialed by the payers to provide mental health counseling, diagnostic interviews, etc. Their diagnostic statement can definitely be used in those circumstances. They also can have hospital priveleges, so in the inpatient (facility), you can take a diagnostic statement from a psychologist in order to arrive at the DRG.

I would suggest that if your co-worker is giving out coding advice that they may want to become a certified coder so that they give out correct advice!

Have a good week.
 
secondary neoplasm pleural fluid

Hello, Pam

I have a discussion at work. Malignant metastatic pleural fluid . from cytology thin prep and cell block. I coded c78.2, the report did not have conclusive for primary malignant. I was corrected, and told that because it is fluid and not tissue I cannot use c78.2, I have to use j91.0 and c34.90 primary since the stain said it may be lung. this went up to the coding director.

Can you advise please. I checked the SEER 2016 manual for cancer classification but it did not provide much on the way of diagnosis.

thank you,

BTY-I took my CPB in Dover, NH!
 
Malignant metastatic pleural fluid is coded as the J91.0, however since it is not documented as to the primary neoplasm you will need to use the C80.1 for unknown primary. you must sequence the C80.1 first and the J91.0 second. You cannot assume the primary malignancy is the lung. there are times when the pathology can detect a metastatic neoplasm without having established where the primary is so C80.1 is an acceptable unspecified code.
 
mitchellde said:
Malignant metastatic pleural fluid is coded as the J91.0, however since it is not documented as to the primary neoplasm you will need to use the C80.1 for unknown primary. you must sequence the C80.1 first and the J91.0 second. You cannot assume the primary malignancy is the lung. there are times when the pathology can detect a metastatic neoplasm without having established where the primary is so C80.1 is an acceptable unspecified code.
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In other words: C78.2 is wrong to use for malignant metastatic pleural fluid, and can only be used for tissue specimens. Which means the same concept applies to malignant ascites.

would C78.2 j910 be wrong for Malignant metastatic pleural fluid ?

Thank you so MUCH for getting back so soon.
PMacc
 
you would not use the C78.2 at all for the diagnosis for Malignant metastatic pleural fluid. as I said since the primary site is unknown at this time you will have to C80.1 as you primary neoplasm site and you primary diagnosis code, the J91.0 will code the metastatic malignant pleural fluid but it must be a secondary code. The code for malignant ascites is R18.0 and is also a secondary only code, you must code the neoplasm first.
 
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Pam Brooks said:
Psychologists are credentialed by the payers to provide mental health counseling, diagnostic interviews, etc. Their diagnostic statement can definitely be used in those circumstances. They also can have hospital priveleges, so in the inpatient (facility), you can take a diagnostic statement from a psychologist in order to arrive at the DRG.

I would suggest that if your co-worker is giving out coding advice that they may want to become a certified coder so that they give out correct advice!

Have a good week.
Click to expand...


That was pretty much my exact wording. ;) Thank you.
 
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