CDI and Coders Blog...

2/10/2019

Argy

2/10/2019 12:10:13 pm

I got this article from a website and it states;

As of October 1, 2017 the note under the code J44.0 COPD (chronic obstructive pulmonary disease, with acute lower respiratory infection) was changed from “Use additional code to identify infection” to “Code also to identify the infection”. A “code also” note does NOT give a sequencing directive as the “use additional code” does. The PDX should be assigned based on the circumstances of the admission.

Yarlene

2/10/2019 05:35:55 pm

In this particular case If the COPD with respiratory infection. If given this case with no other commorbidies or a systemic infection present on admission. Review of documentation to clarify if COPD was exacerbated by the infection. If it was and they were both equally treated, POA and meet the definitions for principal diagnosis. the following guideline may be applied. "when two or more diagnosis equally meet the definition of principal diagnosis as determined by the circumstances of admission, diagnosis workup and therapy provided and alphabetic index does not provide sequencing direction. Any one diagnosis can be sequenced first. However if COPD was not exacerbated and treatment was focused towards the Infection then the infection would be the one condition determined after study to be chiefly responsible for causing the admission. we can also consider chapter for infections and parasitic diseases take precedence over other chapter (except pregnancy), then we can rely on instructional notes in this chapter for coding order of the organism if no combination code is available.

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Grateful for you writing this blog.

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