Rib fx during CPR coded as HAC?

mannb1

Hello all,
I've seen a couple of comments on this topic, but would like to have more input on this. If during CPR, rib fx occur, (so they are not POA), how are your facilities coding these? Per coding clinic -1Q 2013, Page 15: code the fx 807.00 and use E-879.8, but it clearly states this is not a complication......but it pops up as a HAC. Could it be considered an incidental finding, that truly does not meet the UHDDS criteria for a reportable condition?
Just curious how everyone is handling these, as we've had two recently, and can't believe that our CPR technique it at fault?

thanks for your responses,
Becky Mann, RN, CCDS

debra.stewart@halifaxregional.com

AT our facility we are not coding things like this as a complication-being that it is an incident that can happen as a part of CPR. A complication is something that is more than routinely expected-fx ribs can be expected with CPR, especially in a frail individual. Hope that makes sense.
Deb

kbenson@uwhealth.org

It is my understanding that the fracture code is what identifies it as a HAC, not the complication code. Rib fractures during CPR along with intraoperative fractures during ortho procedures (not uncommon) are considered HACs as there is no way to effectively weed these out. The good news is that everyone else is in the same boat when it comes to these as a fracture (800-829) that does not have a POA of N get thrown into this HAC. Medicare is aware of this so it will be interesting to see if this changes in the future.


Kathy Benson RN, BSN, CCDS
Supervisor, Clinical Documentation Integrity
UWHealth University of Wisconsin Hospital & Clinics
600 Highland Avenue, Mail Code 7685
Office number F2/402
Madison, WI  53792
Phone: 608-890-5935

kbenson@uwhealth.org

That DOES have a POA of N. Sorry...