pna and cystic fibrosis

arsusott@msn.com

I have more of a coding question today... Pt is 12 yrs old with a hx of cystic fibrosis. Comes in with pna and sputum is growing staph. He is on the following meds normally:
1. Albuterol nebulizers p.r.n.
2. Pulmozyme daily.
3. Hypertonic saline daily.
4. Vest ThAIRapy daily.
5. Advair.
6. ADEKs vitamins.
7. Pancreatic enzymes.

He will ocntinue on the above meds during hospitalization. The pt isn't in any respiratory distress at present. Would this automatically be "coded" as cystic fibrosis with pulmonary manifestation 277.02 (which is a mcc) since the pt is having pna or do I need to query for pulmonary manifestation?

Thanks for your help.

catladyrn

Ooh, I always have such trouble with cystic fibrosis as to whether it is principal or secondary. We at least are lucky here in that the pulmonologists always write CF w/pulmonary manifestations and even include the ICD-9 code in their notes. But in your situation, I think this coding clinic applies if you substitute pneumonia for bronchitis so that you could take the CF w/o querying:

Acute bronchitis in patient with cystic fibrosis
Coding Clinic, Fourth Quarter 2002
Question:

A three-year-old patient with known cystic fibrosis is admitted to the hospital for treatment of acute bronchitis. How should this be coded?

Answer:

Assign code 466.0, Acute bronchitis, as the principal diagnosis since this condition meets the definition of principal diagnosis. Assign code 277.02, Cystic fibrosis with pulmonary manifestations, as an additional diagnosis.

Renee


Linda Renee Brown, RN, CCRN, CCDS
Certified Clinical Documentation Specialist
Banner Good Samaritan Medical Center

arsusott@msn.com

Thank you for your response totally missed that coding clinic:)