Alcohol intoxication vs poisening

katysuegood@gmail.comkatysuegood@gmail.com
in CDI Talk Archive
We seem to have an issue where physicians document 'alcohol intoxication' even when a patient is so intoxicated they have organ failure and/or require ICU admission. It seems Poisoning would be a more appropriate dx from a coding standpoint but this doesn't seem to be common verbiage here. Anyone else have this issue? If so, have you developed education materials related to this?

Thanks!

Katy Good, RN, BSN, CCDS, CCS
Clinical Documentation Program Coordinator
AHIMA Approved ICD-10CM/PCS Trainer
Flagstaff Medical Center
Kathryn.Good@nahealth.com
Cell: 928.814.9404

Comments

  • katysuegood@gmail.comkatysuegood@gmail.com
    edited April 2016
    So it seems I am the only one dealing with this. Or, this is such a dumb question no one wants to respond ;-)

    Additional complexity is that if a patient ends up with respiratory (if vented) or another severe organ failure it may be better from a revenue standpoint to be able to code the organ failure as PDX. But if they say poisoning, that sequences the ETOH poisoning as Pdx. Other the other hand, if the patient is not vented and basically is admitted to detox and wake up, not having poisoning documented may make us end up in the alcohol/drug abse DRG which is low weight....

    Katy Good, RN, BSN, CCDS, CCS
    Clinical Documentation Program Coordinator
    AHIMA Approved ICD-10CM/PCS Trainer
    Flagstaff Medical Center
    Kathryn.Good@nahealth.com
    Cell: 928.814.9404

  • angelisa.romanelloangelisa.romanello
    edited April 2016
    Hello Katy,
    We actually have a query that we use to ask the provider which diagnosis occasioned the admission, " the alcohol poisoning or the respiratory failure."
    This helps us on occasion however we deal with this frequently as the patient show up at our ER to dry out and then go to our psych hospital.

    I have had to do a great deal of one on one education with the providers especially for the patients who remain vented for several days or who may experience severe withdrawal which will keep them in our ICU. I hope this helps a little.
    Lisa


    Lisa Romanello, RN,BSN,FNS,CCDS
    Manager, Clinical Documentation Improvement
    Quality and Compliance
    CJW Medical Center
    Office phone: 804-228-6527
    Cell phone: 804-629-0396
    AHIMA Approved ICD-10 CM/PCS Trainer
    Angelisa.Romanello@HCAHealthcare.com




  • debra.stewart@halifaxregional.comdebra.stewart@halifaxregional.com
    edited April 2016
    Hi Katy,

    I wanted to respond to this one...but really don't know how to argue this case either...we do have this diagnosis often of "alcohol intoxication" that cause: yes resp. failure, DT's, and they end up in our ICU too. Sometimes I use a cause and effect query to get the doctors to relate the relationship between the alcohol and the manifestations. This has always been a hard one for us too.

    Deb


    Debra Stewart, RN, BSN,
    Clinical Documentation Specialist
    Halifax Regional Health System
    2204 Wilborn Avenue
    South Boston, Va. 24592
    (W) 434-517-3317
    (C) 434-222-9884
    Debra.stewart@halifaxregional.com



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