One more question regarding ABL Anemia.
I'm trying to balance what our CV surgeon believes vs what I am being told by my director and administration.
Our CV surgeon feels like ABL anemia is inherent in his surgeries and has stated he will not document it as a separate diagnosis even when anemia is severe and numerous transfusions are required. However, I am still supposed to be continue to query for it (when appropriate). I have read the related coding clinics and as I understand them, it is appropriate to code post-op anemia (285.1) if the provider documents it, even if they document it as expected.
I want to be careful not to be pushing for this diagnosis when it is inappropriate and I know my queries are being scrutinized by our surgeon.
My questions are as follows;
1. Do you query for anemia (post-op/ABL) after cardiac surgeries?
2. Are your criteria for querying the same as for otehr instances of ABL anemia or do you require a more significant blood loss or treatment because significant blood loss is expected in many of these procedures?
3.What criteria are you looking for to initiate a query?
I'm sorry for all the questions, I am reletively new to this and want to be especially careful given the circumstances.
Thank you!
Katy
Our CV surgeon feels like ABL anemia is inherent in his surgeries and has stated he will not document it as a separate diagnosis even when anemia is severe and numerous transfusions are required. However, I am still supposed to be continue to query for it (when appropriate). I have read the related coding clinics and as I understand them, it is appropriate to code post-op anemia (285.1) if the provider documents it, even if they document it as expected.
I want to be careful not to be pushing for this diagnosis when it is inappropriate and I know my queries are being scrutinized by our surgeon.
My questions are as follows;
1. Do you query for anemia (post-op/ABL) after cardiac surgeries?
2. Are your criteria for querying the same as for otehr instances of ABL anemia or do you require a more significant blood loss or treatment because significant blood loss is expected in many of these procedures?
3.What criteria are you looking for to initiate a query?
I'm sorry for all the questions, I am reletively new to this and want to be especially careful given the circumstances.
Thank you!
Katy
Comments
Donna
Postoperative anemia
      Coding Clinic, First Quarter 2007 Page: 19 Effective with discharges: March 30, 2007
      Related Information
Question:
What is the correct code assignment for postoperative anemia? Coding Clinic Second Quarter 1992, pages 15-16, stated, "If the physician documents postoperative anemia in the medical record, but does not label the condition as a complication, assign code 285.1, Acute posthemorrhagic anemia." Is this advice still valid?
Answer:
When postoperative anemia is documented without specification of acute blood loss, code 285.9, Anemia, unspecified, is the default. Code 285.1, Acute posthemorrhagic anemia, should be assigned, when postoperative anemia is due to acute blood loss. Revisions were made to the Alphabetic Index in 2004, which direct the coder in the following manner:
Anemia
postoperative
due to blood loss 285.1
other 285.9
The directives in the ICD-9-CM manual take precedence over advice published in Coding Clinic.
© Copyright 1984-2011, American Hospital Association ("AHA"), Chicago, Illinois. Reproduced with permission. No portion of this publication may be copied without the express, written consent of AHA.
a drop by 2 points in Hgb; when the md writes anemia; and but not only if transfusions initiated.
This might be a work around for that surgeon.
I am defintely querying if anemia is mentioned for a cause. I guess I am really questioning querying for the anemia itself when it is not mentioned. When we only have a significant drop in H/H requiring transfusions, I generally query for a diagnosis to corrolate with teh lab value and treatment. Our other surgeons routinely document "expected ABL anemia" when appropriate. I guess this physicians argument is that if it was expected, it is inherent in the procedure and does not require additional documentation.
Thank you for your responses.
Katy
Robert
Robert S. Hodges, BSN, MSN, RN, CCDS
Clinical Documentation Improvement Specialist
Aleda E. Lutz VAMC
Mail Code 136
1500 Weiss Street
Saginaw MI 48602
P: 989-497-2500 x13101
F: 989-321-4912
E: Robert.Hodges2@va.gov
"We are dealing with Veterans, not procedures; With their problems, not ours." --General Omar Bradley