ESRD with both HTN and DM - what is the correct sequencing?

tpeyton1tpeyton1
in Clinical & Coding
now that renal is linked to both and each has a different code changing the DRG based on which code is used.  IS there a correct way to sequence these?   with my endcoder, the HTN + ESRD has a higher Relative weight -   
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Comments

  • lostwaterlostwater
    Which is higher in acuity? Which caused the admittance to inpatient (which could not be treated in  the outpatient setting). Which consumed the greatest resources?

    Mark
  • hooter1964hooter1964

    Dr Gold>

    Which diagnosis required inpatient care?  

    Which diagnosis was new and required urgent treatment?

    Not which diagnosis was already known and would be able to start treatment whenever it was desired? 


  • tpeyton1tpeyton1
    Thank you for your responses -   Both  HTN and DM were POA as this is a patient with a history of both and refused HD.     the main reason the patient was admitted was for the renal status and an attempt to encourage initiation of HD.     This questions falls into the  combined code use and if there is anything out there directing one over the other underlying contributing medical condition.   Just curious....
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