Bronchiectasis w/ Pneumonia
When I code:
J470 - Bronchiectasis w/ acute lower respiratory infection
+
J189 - Pneumonia
=
DRG is 192 - COPD w/o CC/MCC
But when I code:
J440 - COPD w/ acute lower respiratory infection
+
J189 - Pneumonia
=
DRG is 190 - COPD w/ MCC
I cannot find any coding rule that explains this.
Thanks everyone!
Jeanne McCorkle, BSN, RN, CCDS
J470 - Bronchiectasis w/ acute lower respiratory infection
+
J189 - Pneumonia
=
DRG is 192 - COPD w/o CC/MCC
But when I code:
J440 - COPD w/ acute lower respiratory infection
+
J189 - Pneumonia
=
DRG is 190 - COPD w/ MCC
Why is PNA not an MCC with Bronchiectasis, but is an MCC with COPD?
I cannot find any coding rule that explains this.
Thanks everyone!
Jeanne McCorkle, BSN, RN, CCDS
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Comments
Hi Jeanne,
Per the CMS website https://www.cms.gov/ICD10Manual/version32-fullcode-cms/fullcode_cms/P1222.html
and table PDX Collection 0734:117 codes on the website
the J189 is excluded as an MCC when J470 is PDx.
Patty Vitasinski RN CCDS
Henry Ford Health System
pvitasi2@hfhs.org
If I understand the attachment from the CMS Definitions manual, if two dx are in the same group they will cancel each other's CC/MCC? That answers my question about what happened.
It doesn't make sense to me, though, that J440 COPD would not also be listed in that group then. Alas! such is the world of Coding. : )
Patty