Adding a new diagnosis after discharge-HELP
We have a provider that will not add a new diagnosis after discharge, despite evidence it was present (clinical indicators). He claims he knows someone in coding and states it is fraud to do so. I have provided our physician advisor information regarding fraud, but they feel this is not enough, and they need 'proof' and or language that states it is acceptable to add a diagnosis to the discharge summary that was not mentioned during the actual stay. (ie. Mortality review query). I am not having success finding a guideline or practice brief that has this language. Can someone help me?
Comments
Good Afternoon, I have attached the link to the 2019 ACDIS update for achieving a compliant query. This is not considered fraud and does occur with other diagnoses with an example of pathology results, or testing results not yet reported at discharge.
2019 update: Guidelines for achieving a compliant query practice | ACDIS