Recent Coding Clinic Decisions

Coding Clinic has been very busy the last few months.  A number of questions addressed have implications for everyday coding:

Coding Clinic (Q3 2011) was asked what the correct coding for a diagnostic statement of depression and anxiety.  Coding Clinic advised that the correct coding was 311 and 300.00, NOT 300.4, because the physician had not established a linkage between the two conditions.

Coding Clinic (Q3 2011) was also asked about the clinical significance of obesity or morbid obesity, when the physician does not do any further assessment, monitoring or care for the condition.   Coding Clinic indicated that these patients are at increased risk of certain medical conditions, and that they should be coded when documented by the physician.

The question of a diagnostic statement of "pneumonia with hemoptysis" was raised. Coding Clinic (Q3 2011) pointed out that hemoptysis is a Chapter 16 code, and as such should not be coded if it was integral to a disease process.
Finally, in Q4 2011, Coding Clinic was asked how a diagnosis of chemotherapy induced pancytopenia was coded.  The questioner was advised to code 284.11, Antineoplastic chemotherapy induced pancytopenia.  Further, the questioner was told that it was unnecessary to code E933.1, Antineoplastic and immunosuppressive drugs, since it was inherent in the title of 284.11.  However, providers could choose to capture this information if they wished.

We'll continue to monitor Coding Clinic rulings, and provide you information here.