Principal Diagnosis for Adolescent "Failure to Thrive" (not d/t anorexia)

lostwater

Hi folks, something you may see in your hospitals, hoping to get some ideas:

Some medical insurance companies will not pay for an inpatient medical hospital stay with a psychiatric principal diagnosis - even in children with autism.

While we know it is not the autism that the child gets admitted, it is the acute medical issue that occasions the admission.  In the the case of a autistic adolescent that gets admitted because of "Failure to thrive", are your hospitals querying (and getting confirmation of) the principal diagnosis being some form of malnutrition, or, do your coders choose dehydration as the principal.

I guess much would depend on the aggressive treatment - nutrition support would go to malnutrition (ok with an inpatient admission for malnutrition?) and IV fluids would go to dehydration (seen as a reason for acute inpatient admission more frequently in the adult space).

Whats your take?  What principal diagnosis do you use?

Thanks,

Mark

morris-jeff@CooperHealth.edu

Mark,

Which payers are denying? APR or MS-DRG?

Shoot me an email later.

jwmorris@health.southalabama.edu

Jeff

jackietouch@aol.com

I would look for indicators, risk factors, and treatment for malnutrition and query. Of course, as you stated, depends on the treatment rendered. If there are no indicators or treatment for either malnutrition or dehydration, failure to thrive can be used as PDx (not ideal, but could happen).

Jackie Touch

morris-jeff@CooperHealth.edu

Unfortunately sometimes FTT is what you are stuck with but many times they will document dehydration, but always look for indicators of malnutrition in this vulnerable population.

Jeff

jackietouch@aol.com said:

I would look for indicators, risk factors, and treatment for malnutrition and query. Of course, as you stated, depends on the treatment rendered. If there are no indicators or treatment for either malnutrition or dehydration, failure to thrive can be used as PDx (not ideal, but could happen).

Jackie Touch