Subdural hemorrhage with expansion

Neuro not my forte.

(#1) If a patient falls after admission and is positive for subdural hematoma (HAC), and within several hours declines rapidly and ct shows "massive subdural bleed with midline shift and mass effect with intraventricular hemorrhage and brainstem herniation" -- how does this code out? Do you code the subdural hemorrhage traumatic (where bleed originated) or do you code to the level of the intraventricular hemorrhage even though that wasn't the origination point?

(#2) Am I able to also code the compression of brain (brainstem herniation) or is that considered integral to the traumatic hemorrhage injury code and not separately codeable?

Thank you in advance!!

Comments

  • blockquote, div.yahoo_quoted { margin-left: 0 !important; border-left:1px #715FFA solid !important; padding-left:1ex !important; background-color:white !important; } It is Not intrigal ... Also code venticle hemorrhage if the stated it. Based on the finding be sure the physician states the correct terms of "brain compression  & brainstem herniation"  mass effect midline shift don't count You can also capture the GCS if not sedated with the brain injury & there maybe also comatose opportunity 
    Laurie 
    Sent from Yahoo Mail for iPhone


    On Friday, April 15, 2016, 12:57 PM, CDI Talk wrote:


    Neuro not my forte. 

     

    (#1) If a patient falls after admission and is positive for subdural hematoma (HAC), and within several hours declines rapidly and ct shows “massive subdural bleed with midline shift and mass effect with intraventricular hemorrhage and brainstem herniation”  --  how does this code out?  Do you code the subdural hemorrhage traumatic (where bleed originated) or do you code to the level of the intraventricular hemorrhage even though that wasn’t the origination point?

     

    (#2)  Am I able to also code the compression of brain (brainstem herniation) or is that considered integral to the traumatic hemorrhage injury code and not separately codeable?

     

    Thank you in advance!!
    DISCLAIMER: The information contained in this transmission may contain privileged and confidential information, including patient information protected by federal and state privacy laws. It is intended only for use by the intended recipient. If you are not the intended recipient, you are hereby notified that any review, dissemination, distribution, or duplication of this communication is strictly prohibited. The partaking of any action in reliance upon this information by persons or entities other than the intended recipient is illegal and a violation of the regulatory guidance in the Health Insurance Portability and Accountability Act (HIPAA). If you received this in error, please contact the sender immediately and delete the material from all computers. ---
    CDI Talk is offered for networking purposes. For official rules and regulations related to documentation and coding, please refer to your regulatory source.

    You are receiving this message as a member of CDI Talk as: johnlaul@yahoo.com
    If you would like to be removed from CDI Talk, please send a blank email to
    leave-cdi_talk-20303862.4a49c1740d9ed0c21b22bcbebe576e32@hcprotalk.com
    ---
    Copyright 2013
    HCPro, Inc., 75 Sylvan Street, Danvers MA 01923
  • Thank you. When I put the brain compression into 3M asked if it was due to trauma and after walking through the tree the only code given was the Trauma/injury code and not an additional code for the compression so I thought maybe with “traumatic injury” it was considered integral and not separately coded. I couldn’t find any guidelines/coding clinics that addressed it though. Appreciate your input.

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Friday, April 15, 2016 12:36 PM
    To: Hoffmeister, Loretta
    Subject: Re: [cdi_talk] Subdural hemorrhage with expansion

    It is Not intrigal ... Also code venticle hemorrhage if the stated it.
    Based on the finding be sure the physician states the correct terms of "brain compression & brainstem herniation" mass effect midline shift don't count
    You can also capture the GCS if not sedated with the brain injury & there maybe also comatose opportunity

    Laurie

    Sent from Yahoo Mail for iPhone

    On Friday, April 15, 2016, 12:57 PM, CDI Talk wrote:
    Neuro not my forte.

    (#1) If a patient falls after admission and is positive for subdural hematoma (HAC), and within several hours declines rapidly and ct shows “massive subdural bleed with midline shift and mass effect with intraventricular hemorrhage and brainstem herniation” -- how does this code out? Do you code the subdural hemorrhage traumatic (where bleed originated) or do you code to the level of the intraventricular hemorrhage even though that wasn’t the origination point?

    (#2) Am I able to also code the compression of brain (brainstem herniation) or is that considered integral to the traumatic hemorrhage injury code and not separately codeable?

    Thank you in advance!!
    DISCLAIMER: The information contained in this transmission may contain privileged and confidential information, including patient information protected by federal and state privacy laws. It is intended only for use by the intended recipient. If you are not the intended recipient, you are hereby notified that any review, dissemination, distribution, or duplication of this communication is strictly prohibited. The partaking of any action in reliance upon this information by persons or entities other than the intended recipient is illegal and a violation of the regulatory guidance in the Health Insurance Portability and Accountability Act (HIPAA). If you received this in error, please contact the sender immediately and delete the material from all computers.

    ---

    CDI Talk is offered for networking purposes. For official rules and regulations related to documentation and coding, please refer to your regulatory source.



    You are receiving this message as a member of CDI Talk as: johnlaul@yahoo.com

    If you would like to be removed from CDI Talk, please send a blank email to

    leave-cdi_talk-20303862.4a49c1740d9ed0c21b22bcbebe576e32@hcprotalk.com

    ---

    Copyright 2013

    HCPro, Inc., 75 Sylvan Street, Danvers MA 01923



    ---

    CDI Talk is offered for networking purposes. For official rules and regulations related to documentation and coding, please refer to your regulatory source.



    You are receiving this message as a member of CDI Talk as: loretta.hoffmeister@samcstl.org

    If you would like to be removed from CDI Talk, please send a blank email to

    leave-cdi_talk-20295371.7741374e7d6483785fa9689893d4f7f7@hcprotalk.com

    ---

    Copyright 2013

    HCPro, Inc., 75 Sylvan Street, Danvers MA 01923

    DISCLAIMER: The information contained in this transmission may contain privileged and confidential information, including patient information protected by federal and state privacy laws. It is intended only for use by the intended recipient. If you are not the intended recipient, you are hereby notified that any review, dissemination, distribution, or duplication of this communication is strictly prohibited. The partaking of any action in reliance upon this information by persons or entities other than the intended recipient is illegal and a violation of the regulatory guidance in the Health Insurance Portability and Accountability Act (HIPAA). If you received this in error, please contact the sender immediately and delete the material from all computers.
  • This is one of those weird coding nuances. Even though brain compression and brain herniation are the same diagnosis code (G93.5), compression d/t trauma gets “absorbed” into the head injury; whereas brain herniation does not.

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Friday, April 15, 2016 1:40 PM
    Subject: RE: [cdi_talk] Subdural hemorrhage with expansion

    Thank you. When I put the brain compression into 3M asked if it was due to trauma and after walking through the tree the only code given was the Trauma/injury code and not an additional code for the compression so I thought maybe with “traumatic injury” it was considered integral and not separately coded. I couldn’t find any guidelines/coding clinics that addressed it though. Appreciate your input.

    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Friday, April 15, 2016 12:36 PM
    To: Hoffmeister, Loretta
    Subject: Re: [cdi_talk] Subdural hemorrhage with expansion

    It is Not intrigal ... Also code venticle hemorrhage if the stated it.
    Based on the finding be sure the physician states the correct terms of "brain compression & brainstem herniation" mass effect midline shift don't count
    You can also capture the GCS if not sedated with the brain injury & there maybe also comatose opportunity

    Laurie

    Sent from Yahoo Mail for iPhone

    On Friday, April 15, 2016, 12:57 PM, CDI Talk wrote:
    Neuro not my forte.

    (#1) If a patient falls after admission and is positive for subdural hematoma (HAC), and within several hours declines rapidly and ct shows “massive subdural bleed with midline shift and mass effect with intraventricular hemorrhage and brainstem herniation” -- how does this code out? Do you code the subdural hemorrhage traumatic (where bleed originated) or do you code to the level of the intraventricular hemorrhage even though that wasn’t the origination point?

    (#2) Am I able to also code the compression of brain (brainstem herniation) or is that considered integral to the traumatic hemorrhage injury code and not separately codeable?

    Thank you in advance!!
    DISCLAIMER: The information contained in this transmission may contain privileged and confidential information, including patient information protected by federal and state privacy laws. It is intended only for use by the intended recipient. If you are not the intended recipient, you are hereby notified that any review, dissemination, distribution, or duplication of this communication is strictly prohibited. The partaking of any action in reliance upon this information by persons or entities other than the intended recipient is illegal and a violation of the regulatory guidance in the Health Insurance Portability and Accountability Act (HIPAA). If you received this in error, please contact the sender immediately and delete the material from all computers.

    ---

    CDI Talk is offered for networking purposes. For official rules and regulations related to documentation and coding, please refer to your regulatory source.



    You are receiving this message as a member of CDI Talk as: johnlaul@yahoo.com

    If you would like to be removed from CDI Talk, please send a blank email to

    leave-cdi_talk-20303862.4a49c1740d9ed0c21b22bcbebe576e32@hcprotalk.com

    ---

    Copyright 2013

    HCPro, Inc., 75 Sylvan Street, Danvers MA 01923



    ---

    CDI Talk is offered for networking purposes. For official rules and regulations related to documentation and coding, please refer to your regulatory source.



    You are receiving this message as a member of CDI Talk as: loretta.hoffmeister@samcstl.org

    If you would like to be removed from CDI Talk, please send a blank email to

    leave-cdi_talk-20295371.7741374e7d6483785fa9689893d4f7f7@hcprotalk.com

    ---

    Copyright 2013

    HCPro, Inc., 75 Sylvan Street, Danvers MA 01923
    DISCLAIMER: The information contained in this transmission may contain privileged and confidential information, including patient information protected by federal and state privacy laws. It is intended only for use by the intended recipient. If you are not the intended recipient, you are hereby notified that any review, dissemination, distribution, or duplication of this communication is strictly prohibited. The partaking of any action in reliance upon this information by persons or entities other than the intended recipient is illegal and a violation of the regulatory guidance in the Health Insurance Portability and Accountability Act (HIPAA). If you received this in error, please contact the sender immediately and delete the material from all computers.
  • Tagging onto this thread! I thought herniation could be coded separately in traumatic hemorrhages (as opposed to compression) but I just did it and I got an Excludes 1.

    Did this change with ICD-10??

    Thanks!

    Katy Good
  • [cid:image001.png@01D1A77B.905E9A30]



    Katy Good, RN, BSN, CCDS, CCS

    Clinical Documentation Program Coordinator

    Flagstaff Medical Center

    Kathryn.Good@nahealth.com

    Cell: 928.814.9404





    -----Original Message-----
    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Friday, May 06, 2016 9:43 AM
    To: Kathryn Good
    Subject: RE:[cdi_talk] Subdural hemorrhage with expansion



    Tagging onto this thread! I thought herniation could be coded separately in traumatic hemorrhages (as opposed to compression) but I just did it and I got an Excludes 1.



    Did this change with ICD-10??



    Thanks!



    Katy Good

    ---

    CDI Talk is offered for networking purposes. For official rules and regulations related to documentation and coding, please refer to your regulatory source.



    You are receiving this message as a member of CDI Talk as: kathryn.good@nahealth.com If you would like to be removed from CDI Talk, please send a blank email to leave-cdi_talk-12649561.a6bbaf3538c19e934e5136fbd051a6b1@hcprotalk.com

    ---

    Copyright 2013

    HCPro, Inc., 75 Sylvan Street, Danvers MA 01923 This message has been scanned and no issues were detected.

    Do not trust links or attachments and do not divulge sensitive information upon email request.



    To report this email as SPAM, please forward it to spam@websense.com
Sign In or Register to comment.