I-10 and contrast specificity?

Hi all,
For those of you working on I-10 documentation issues, how are you handling the contrast specificity for cath procedures (for example)? Our coding manager has said that she saw that we should default to ‘Low’ if it is unspecified but I haven’t been able to locate this information.
Anyone familiar with this?

Katy Good, RN, BSN, CCDS, CCS
Clinical Documentation Program Coordinator
AHIMA Approved ICD-10CM/PCS Trainer
Flagstaff Medical Center
Kathryn.Good@nahealth.com
Cell: 928.814.9404

Comments

  • We were told the contrast material will always be listed on our MARS (EPIC), and the coders will be given a reference chart to determine whether the media is high or low osmolality. Our contact in Radiology stated that they almost always use low, and asked if we could code by exception i.e. assume low osmolar unless someone says differently?
    Our ICD-10 Education Coordinator stated, “We can create a facility-specific coding policy if you can assure us that radiologists always use low osmolar for IV contrast and will document high osmolar when used; however, the ideal solution is to have the contrast agent & it’s osmolality on every report."
    So to answer your question, I haven't seen any official guidance regarding defaulting to 'low', but it sounds like a possible (but not ideal) solution.
    Thanks,
    Donna Fisher, CCS, CCDS
    CDI Coordinator
    UFHealth Shands Hospital


  • Ha! I love it when I find I've asked the same questions multiple times :). We are working on making 'Low' a part of the order but IT is concerned this will not be in place on time. Then today coding pointed out that they need to know if plain radiology vs fluoroscopy is used during our cholangiographies. They only use flouro and now they want to know if we can make a 'policy' for this (I am sure there will be more).

    I have 'heard' that there is some guidance as to such 'policies' but I can't find it.....

    Thanks for your help!

    Katy Good, RN, BSN, CCDS, CCS
    Clinical Documentation Program Coordinator
    AHIMA Approved ICD-10CM/PCS Trainer
    Flagstaff Medical Center
    Kathryn.Good@nahealth.com
    Cell: 928.814.9404

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