Positive ELISA for Lyme disease

pscheiderichpscheiderich
in Clinical & Coding

At time of discharge patient had a positive ELISA but the Western Blot was still pending.  The physician listed IMO problem "positive ELISA for Lyme disease".  The Western Blot is back now and is also positive.  Can this be coded as Lyme disease or is a query needed to clarify if Lyme disease was confirmed?

Appreciate any input.

Comments

  • afrady@blr.comafrady@blr.com
    "Positive ELISA for Lyme disease" would likely be reported as an abnormal finding via coding.

    Do you have any other documentation at the time of discharge that the MD suspected, was treating, or had other evidence of Lyme disease besides notation of the lab findings?    As it stands right now, you would need to query.
  • evanspx@sutterhealth.orgevanspx@sutterhealth.org
    Concur a query  would be in order.  For coding and compliance adherence, the MD must ‘name’ this as a disease rather than a laboratory finding.  This would be coded as an abnormal finding.
  • pscheiderichpscheiderich
    I'm sorry I should have included that.  The patient had recurrent Bell's palsy and that is why the Lyme disease testing was ordered. 
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