Drop in hemoglobin

This goes out to any coders in the group. Patient with principal diagnosis "UGIB unspecified". Physician documents "acute drop in H/H" and the lab fingings and treatment support the documentation.

Now, we use the 3M encoder. When you enter "drop" the next screen gives option of "Hematocrit (precipitous) and "Hemoglobin". If you select "Hemoglobin" It gives you 790.01. This code will move the DRG because it is a "cc". When you reference the code book it shows

790.01 Precipitous drop in hematocrit
Drop in Hematocrit
Drop in Hemoglobin

can this be coded based on the documentation in the chart?

I have been told it cannot because it is only a lab finding. If this is correct, why would it be listed in the coding book? I know it could be a query opportunity for perhaps "acute blood loss anemia", but if the documentation will will give you a "cc" as it is written a query may not be necessary unless you are wanting to capture SOI.

I reaaly just wander if "acute drop in H/H" can be coded as documented. Please advise.

Comments

  • edited May 2016
    This is something that we will include as a query option and will code. Can not code if there is documentation in the chart of any variety of anemia. Agreed, would prefer to capture ABLA....but will take what one can get!

    Don


  • edited May 2016
    So Don, Your coders will code "acute drop in H/H" if there is no conflicting documentation and no response to any query you may have submitted?






  • edited May 2016
    Yes......as long as there is NO documentation of anemia -- in which case that is coded only.


  • edited May 2016
    But if the H/H is being monitored why can't it be coded?


  • edited May 2016
    I think I agree w/Don. We use different software but I got to the same
    code using the same info that you did and yes it is indeed a CC. I would
    take the CC if - as Don says - there is no other mention of Anemia.
    Then I would query for the ABLA.

    It's supported by clinical info. The physician documented it in the
    chart. It is a CC.


    N. Brunson, RHIA
    Clinical Documentation Specialist
    Bay Medical Center


  • edited May 2016
    Monitoring and evaluation is treatment. What if your patient has a
    contraindication and blood cannot be given?


    N. Brunson, RHIA
    Clinical Documentation Specialist
    Bay Medical Center


  • edited May 2016
    I trying to understand this. Your saying if the patient is admitted with any dx of anemia and has a hct drop and your query does not get answered for ABLA you would not code drop in hct?


  • I think the rule is that if the provider documents anemia of any type, the coding rules don't allow you to document a "precipitous drop in hematocrit". I only look for this if I see someone with a HCT above 32 and their baseline is over 40. That way they are technically, at least according to the physicians I've talked to here, anemic, but they have had that 20% drop in HCT.

    Does that make sense?

    Robert

    Robert S. Hodges, BSN, MSN, RN
    Clinical Documentation Improvement Specialist
    Aleda E. Lutz VAMC
    Mail Code 136
    1500 Weiss Street
    Saginaw MI 48602
  • edited May 2016
    I believe Anemia (2851, 2853-2859) is an exclusion for "drop in Hct". If anemia is documented it should be coded and if anemia is coded I think you can't also code the "drop in Hct due to exclusions,but check the ICD9-3M book. My problem is when anemia is not coded, our coders tell us they will not code "drop in H/H" because it is a non-specific lab finding. It is however listed in the ICD-9 book (790.01). This I cannot understand.






  • edited May 2016
    Robert,
    Explained better than I did earlier, Thanks!

    As far as the reluctance to code the 790.01 -- at my facility there are dynamic discussions among the coding community as well as with the CDI's about what the coder's feel comfortable to code and support by ICD9 and coding clinic.
    Part of the job I think.
    Some research into the index and coding clinic might help to engage in a dialog.

    Don



  • edited May 2016
    Do you know where this rule is in the coding guidelines because it is not an exculsion under 285.1 in the icd -9-cm expert.


  • You are correct. It is not an exclusion under 285.1, but if you look in the ICD-9-CM manual for 790.01 (precipitous drop in hematocrit), it states "CC Excl: 285.1, 285.23 - 285.9"

    A bit of inconsistency, but my coders here have confirmed this with me when I asked the question before.

    Robert

    "To climb a steep hill requires a slow pace at first."
  • edited May 2016
    Thank you. It would have been nice if they reference it at both ICD-9 codes.


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