ESLD &/or Cirrhosis

ssalinasssalinas
in CDI Talk Archive
Sending out this question again:

Does 'ascites 2/2 ESLD 2/2 ETOH + hepatitis C" = cirrhosis? Would a query be necessary to get to cirrhosis? I understand that it most likely is but can we make that jump without asking the provider?

-----Original Message-----
From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
Sent: Wednesday, January 27, 2016 10:46 AM
To: Salinas, Sharon
Subject: RE: RE:[cdi_talk] Unrelated DRG help

The hepatitis was not the focus of the admission nor the procedure. The ascites should be first unless there is direction to precede. Looks like K70.11 for alcoholic cirrhosis with ascites should be principal followed by the specific viral hepatitis. That would take the DRG to where it deserves to be.

Robert S. Gold, MD
CEO, DCBA, Inc
4611 Brierwood Place
Atlanta, GA 30360
(770) 216-9691 (Office)
(404) 580-0204 (Cell)

-----Original Message-----
From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
Sent: Wednesday, January 27, 2016 1:11 PM
To: Dr. Robert Gold
Subject: RE: RE:[cdi_talk] Unrelated DRG help

I've got one!!!

I have a patient that came in with massive ascites (leaking out of an umbilical hernia) 2/2 ESLD 2/2 ETOH + Hepatitis C. She had a paracentesis.

The coder has B19.20 (viral hepatitis C) as Pdx and she has the procedure coded as OW9G3ZZ (drainage of peritoneal cavity, perc approach) as Ppx.

We landed in DRG982 (extensive OT procedure unrelated to principle)


Is that right?


Also, I ran a report for these DRG's. We have seen a 4-fold increase since I-10!!!


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


-----Original Message-----
From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
Sent: Tuesday, January 26, 2016 1:21 PM
To: Kathryn Good
Subject: RE: RE:[cdi_talk] Unrelated DRG help

Thanks Dr. Gold : )

Kerry Seekircher, RN, BS, CCDS, CDIP
Clinical Documentation Program Manager
Northern Westchester Hospital
400 East Main Street
Mount Kisco, NY 10549
Email: kseekircher@nwhc.net
Phone: 914-666-1243
Fax: 914-666-1013





-----Original Message-----
From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
Sent: Tuesday, January 26, 2016 3:03 PM
To: Seekircher, Kerry
Subject: RE: RE:[cdi_talk] Unrelated DRG help

Having removed some IJ lines, it's not an open or percutaneous procedure. Even if it were tunneled, it's removal of sutures and PUL-L-L-L-L!! (gently!)

Robert S. Gold, MD
CEO, DCBA, Inc
4611 Brierwood Place
Atlanta, GA 30360
(770) 216-9691 (Office)
(404) 580-0204 (Cell)


-----Original Message-----
From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
Sent: Tuesday, January 26, 2016 2:59 PM
To: Dr. Robert Gold
Subject: RE: RE:[cdi_talk] Unrelated DRG help

Thanks Jeff-that is what I am recommending. I hope we are right!

Kerry Seekircher, RN, BS, CCDS, CDIP
Clinical Documentation Program Manager
Northern Westchester Hospital
400 East Main Street
Mount Kisco, NY 10549
Email: kseekircher@nwhc.net
Phone: 914-666-1243
Fax: 914-666-1013





-----Original Message-----
From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
Sent: Tuesday, January 26, 2016 12:01 PM
To: Seekircher, Kerry
Subject: RE:[cdi_talk] Unrelated DRG help

Kerry,
I am pretty sure this would be external approach because percutaneous requires a puncture or minor incision per the definition. Were sutures just cut and cath pulled? My gut says external but interested to hear what persons with more PCS expertise say.

Jeff
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Comments

  • gwojogwojo
    You cannot assume the cirrhosis; has to be documented by Physician. But, you have adequate ammunition to do so.
    Good luck!

    ----- Original Message -----

    From: "CDI Talk"
    To: gwojo@wowway.com
    Sent: Wednesday, January 27, 2016 2:04:25 PM
    Subject: [cdi_talk] ESLD &/or Cirrhosis

    Sending out this question again:

    Does 'ascites 2/2 ESLD 2/2 ETOH + hepatitis C" = cirrhosis?  Would a query be necessary to get to cirrhosis?  I understand that it most likely is but can we make that jump without asking the provider?

    -----Original Message-----
    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, January 27, 2016 10:46 AM
    To: Salinas, Sharon
    Subject: RE: RE:[cdi_talk] Unrelated DRG help

    The hepatitis was not the focus of the admission nor the procedure.  The ascites should be first unless there is direction to precede.  Looks like K70.11 for alcoholic cirrhosis with ascites should be principal followed by the specific viral hepatitis.  That would take the DRG to where it deserves to be.

    Robert S. Gold, MD
    CEO, DCBA, Inc
    4611 Brierwood Place
    Atlanta, GA 30360
    (770) 216-9691 (Office)
    (404) 580-0204 (Cell)

    -----Original Message-----
    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, January 27, 2016 1:11 PM
    To: Dr. Robert Gold
    Subject: RE: RE:[cdi_talk] Unrelated DRG help

    I've got one!!!

    I have a patient that came in with massive ascites (leaking out of an umbilical hernia) 2/2 ESLD 2/2 ETOH + Hepatitis C. She had a paracentesis.

    The coder has B19.20 (viral hepatitis C) as Pdx and she has the procedure coded as OW9G3ZZ (drainage of peritoneal cavity, perc approach) as Ppx.

    We landed in DRG982 (extensive OT procedure unrelated to principle)


    Is that right?


    Also, I ran a report for these DRG's. We have seen a 4-fold increase since I-10!!!


    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


    -----Original Message-----
    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Tuesday, January 26, 2016 1:21 PM
    To: Kathryn Good
    Subject: RE: RE:[cdi_talk] Unrelated DRG help

    Thanks Dr. Gold : )

    Kerry Seekircher, RN, BS, CCDS, CDIP
    Clinical Documentation Program Manager
    Northern Westchester Hospital
    400 East Main Street
    Mount Kisco, NY 10549
    Email: kseekircher@nwhc.net
    Phone: 914-666-1243
    Fax: 914-666-1013





    -----Original Message-----
    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Tuesday, January 26, 2016 3:03 PM
    To: Seekircher, Kerry
    Subject: RE: RE:[cdi_talk] Unrelated DRG help

    Having removed some IJ lines, it's not an open or percutaneous procedure.  Even if it were tunneled, it's removal of sutures and PUL-L-L-L-L!! (gently!)

    Robert S. Gold, MD
    CEO, DCBA, Inc
    4611 Brierwood Place
    Atlanta, GA 30360
    (770) 216-9691 (Office)
    (404) 580-0204 (Cell)


    -----Original Message-----
    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Tuesday, January 26, 2016 2:59 PM
    To: Dr. Robert Gold
    Subject: RE: RE:[cdi_talk] Unrelated DRG help

    Thanks Jeff-that is what I am recommending. I hope we are right!

    Kerry Seekircher, RN, BS, CCDS, CDIP
    Clinical Documentation Program Manager
    Northern Westchester Hospital
    400 East Main Street
    Mount Kisco, NY 10549
    Email: kseekircher@nwhc.net
    Phone: 914-666-1243
    Fax: 914-666-1013





    -----Original Message-----
    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Tuesday, January 26, 2016 12:01 PM
    To: Seekircher, Kerry
    Subject: RE:[cdi_talk] Unrelated DRG help

    Kerry,
    I am pretty sure this would be external approach because percutaneous requires a puncture or minor incision per the definition. Were sutures just cut and cath pulled? My gut says external but interested to hear what persons with more PCS expertise say.

    Jeff
    ---
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    Copyright 2013
    HCPro, Inc., 75 Sylvan Street, Danvers MA 01923

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  • ssalinasssalinas
    Agree – I was just wondering in regards to Katy’s question earlier.

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, January 27, 2016 12:37 PM
    To: Salinas, Sharon
    Subject: Re: [cdi_talk] ESLD &/or Cirrhosis

    You cannot assume the cirrhosis; has to be documented by Physician. But, you have adequate ammunition to do so.
    Good luck!

    ________________________________
    From: "CDI Talk"
    To: gwojo@wowway.com
    Sent: Wednesday, January 27, 2016 2:04:25 PM
    Subject: [cdi_talk] ESLD &/or Cirrhosis

    Sending out this question again:

    Does 'ascites 2/2 ESLD 2/2 ETOH + hepatitis C" = cirrhosis? Would a query be necessary to get to cirrhosis? I understand that it most likely is but can we make that jump without asking the provider?

    -----Original Message-----
    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, January 27, 2016 10:46 AM
    To: Salinas, Sharon
    Subject: RE: RE:[cdi_talk] Unrelated DRG help

    The hepatitis was not the focus of the admission nor the procedure. The ascites should be first unless there is direction to precede. Looks like K70.11 for alcoholic cirrhosis with ascites should be principal followed by the specific viral hepatitis. That would take the DRG to where it deserves to be.

    Robert S. Gold, MD
    CEO, DCBA, Inc
    4611 Brierwood Place
    Atlanta, GA 30360
    (770) 216-9691 (Office)
    (404) 580-0204 (Cell)

    -----Original Message-----
    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, January 27, 2016 1:11 PM
    To: Dr. Robert Gold
    Subject: RE: RE:[cdi_talk] Unrelated DRG help

    I've got one!!!

    I have a patient that came in with massive ascites (leaking out of an umbilical hernia) 2/2 ESLD 2/2 ETOH + Hepatitis C. She had a paracentesis.

    The coder has B19.20 (viral hepatitis C) as Pdx and she has the procedure coded as OW9G3ZZ (drainage of peritoneal cavity, perc approach) as Ppx.

    We landed in DRG982 (extensive OT procedure unrelated to principle)


    Is that right?


    Also, I ran a report for these DRG's. We have seen a 4-fold increase since I-10!!!


    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


    -----Original Message-----
    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Tuesday, January 26, 2016 1:21 PM
    To: Kathryn Good
    Subject: RE: RE:[cdi_talk] Unrelated DRG help

    Thanks Dr. Gold : )

    Kerry Seekircher, RN, BS, CCDS, CDIP
    Clinical Documentation Program Manager
    Northern Westchester Hospital
    400 East Main Street
    Mount Kisco, NY 10549
    Email: kseekircher@nwhc.net
    Phone: 914-666-1243
    Fax: 914-666-1013





    -----Original Message-----
    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Tuesday, January 26, 2016 3:03 PM
    To: Seekircher, Kerry
    Subject: RE: RE:[cdi_talk] Unrelated DRG help

    Having removed some IJ lines, it's not an open or percutaneous procedure. Even if it were tunneled, it's removal of sutures and PUL-L-L-L-L!! (gently!)

    Robert S. Gold, MD
    CEO, DCBA, Inc
    4611 Brierwood Place
    Atlanta, GA 30360
    (770) 216-9691 (Office)
    (404) 580-0204 (Cell)


    -----Original Message-----
    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Tuesday, January 26, 2016 2:59 PM
    To: Dr. Robert Gold
    Subject: RE: RE:[cdi_talk] Unrelated DRG help

    Thanks Jeff-that is what I am recommending. I hope we are right!

    Kerry Seekircher, RN, BS, CCDS, CDIP
    Clinical Documentation Program Manager
    Northern Westchester Hospital
    400 East Main Street
    Mount Kisco, NY 10549
    Email: kseekircher@nwhc.net
    Phone: 914-666-1243
    Fax: 914-666-1013





    -----Original Message-----
    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Tuesday, January 26, 2016 12:01 PM
    To: Seekircher, Kerry
    Subject: RE:[cdi_talk] Unrelated DRG help

    Kerry,
    I am pretty sure this would be external approach because percutaneous requires a puncture or minor incision per the definition. Were sutures just cut and cath pulled? My gut says external but interested to hear what persons with more PCS expertise say.

    Jeff
    ---
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    Copyright 2013
    HCPro, Inc., 75 Sylvan Street, Danvers MA 01923

    Note:
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    Any views expressed in this message are those of the individual sender, except where the message states otherwise and the sender is authorized to state them to be the views of any such entity.

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    Note:
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  • katysuegood@gmail.comkatysuegood@gmail.com
    Yes. In my case, cirrhosis is documented by the MD.

    ☺

    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

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, January 27, 2016 2:27 PM
    To: Kathryn Good
    Subject: RE: [cdi_talk] ESLD &/or Cirrhosis


    Agree – I was just wondering in regards to Katy’s question earlier.

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, January 27, 2016 12:37 PM
    To: Salinas, Sharon
    Subject: Re: [cdi_talk] ESLD &/or Cirrhosis

    You cannot assume the cirrhosis; has to be documented by Physician. But, you have adequate ammunition to do so.
    Good luck!

    ________________________________
    From: "CDI Talk"
    To: gwojo@wowway.com
    Sent: Wednesday, January 27, 2016 2:04:25 PM
    Subject: [cdi_talk] ESLD &/or Cirrhosis

    Sending out this question again:

    Does 'ascites 2/2 ESLD 2/2 ETOH + hepatitis C" = cirrhosis? Would a query be necessary to get to cirrhosis? I understand that it most likely is but can we make that jump without asking the provider?

    -----Original Message-----
    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, January 27, 2016 10:46 AM
    To: Salinas, Sharon
    Subject: RE: RE:[cdi_talk] Unrelated DRG help

    The hepatitis was not the focus of the admission nor the procedure. The ascites should be first unless there is direction to precede. Looks like K70.11 for alcoholic cirrhosis with ascites should be principal followed by the specific viral hepatitis. That would take the DRG to where it deserves to be.

    Robert S. Gold, MD
    CEO, DCBA, Inc
    4611 Brierwood Place
    Atlanta, GA 30360
    (770) 216-9691 (Office)
    (404) 580-0204 (Cell)

    -----Original Message-----
    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Wednesday, January 27, 2016 1:11 PM
    To: Dr. Robert Gold
    Subject: RE: RE:[cdi_talk] Unrelated DRG help

    I've got one!!!

    I have a patient that came in with massive ascites (leaking out of an umbilical hernia) 2/2 ESLD 2/2 ETOH + Hepatitis C. She had a paracentesis.

    The coder has B19.20 (viral hepatitis C) as Pdx and she has the procedure coded as OW9G3ZZ (drainage of peritoneal cavity, perc approach) as Ppx.

    We landed in DRG982 (extensive OT procedure unrelated to principle)


    Is that right?


    Also, I ran a report for these DRG's. We have seen a 4-fold increase since I-10!!!


    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


    -----Original Message-----
    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Tuesday, January 26, 2016 1:21 PM
    To: Kathryn Good
    Subject: RE: RE:[cdi_talk] Unrelated DRG help

    Thanks Dr. Gold : )

    Kerry Seekircher, RN, BS, CCDS, CDIP
    Clinical Documentation Program Manager
    Northern Westchester Hospital
    400 East Main Street
    Mount Kisco, NY 10549
    Email: kseekircher@nwhc.net
    Phone: 914-666-1243
    Fax: 914-666-1013





    -----Original Message-----
    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Tuesday, January 26, 2016 3:03 PM
    To: Seekircher, Kerry
    Subject: RE: RE:[cdi_talk] Unrelated DRG help

    Having removed some IJ lines, it's not an open or percutaneous procedure. Even if it were tunneled, it's removal of sutures and PUL-L-L-L-L!! (gently!)

    Robert S. Gold, MD
    CEO, DCBA, Inc
    4611 Brierwood Place
    Atlanta, GA 30360
    (770) 216-9691 (Office)
    (404) 580-0204 (Cell)


    -----Original Message-----
    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Tuesday, January 26, 2016 2:59 PM
    To: Dr. Robert Gold
    Subject: RE: RE:[cdi_talk] Unrelated DRG help

    Thanks Jeff-that is what I am recommending. I hope we are right!

    Kerry Seekircher, RN, BS, CCDS, CDIP
    Clinical Documentation Program Manager
    Northern Westchester Hospital
    400 East Main Street
    Mount Kisco, NY 10549
    Email: kseekircher@nwhc.net
    Phone: 914-666-1243
    Fax: 914-666-1013





    -----Original Message-----
    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Tuesday, January 26, 2016 12:01 PM
    To: Seekircher, Kerry
    Subject: RE:[cdi_talk] Unrelated DRG help

    Kerry,
    I am pretty sure this would be external approach because percutaneous requires a puncture or minor incision per the definition. Were sutures just cut and cath pulled? My gut says external but interested to hear what persons with more PCS expertise say.

    Jeff
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