COPD

dvitalone1dvitalone1
in CDI Talk Archive
I need a little guidance. I am new to the CDI role and the department is new at my facility. I am getting conflicting information about a simple issue. When a physcian documents "COPD EXAC" do I need to query for clarification for acute or chronic? I have 3 different people telling me 3 different things/
Thanks!

Comments

  • Unknown
    edited May 2016
    You do not need to query. COPD exac codes to
    "obstructive chronic bronchitis with (acute) exacerbation"

    -----
    Charlene
  • NormaBNormaB
    edited May 2016
    I do not ask for acute unless he only documented "COPD" but it looks as if he is actively treating. If I see they are actively treating an exac. of COPD the I query for acute or exac.

    Norma T.Brunson,RHIA, CCDS

  • cynthia.a.goeweycynthia.a.goewey
    edited May 2016
    I agree, we do not query either for that specificity.
    Cindy



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  • ddraizeddraize
    edited May 2016
    I agree you do not need to query

    Diane Draize RN, CPUR,CCDS
    Clinical Documentation Specialist

    Ministry Door County Medical Center
    diane.draize@ministryhealth.org
    920-743-5566 ex 3143

    We earn trust by working together as One Ministry to keep PATIENTS FIRST in everything we do

  • fentona@bronsonhg.orgfentona@bronsonhg.org
    edited May 2016
    No, "exac" codes to acute.
    :) Amy

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