Glasgow Coma Scale Score

Currently our Coding Team does not code the Glasgow Coma Score. I have presented to them the impact on coding the score but have been met with resistance stating it is too time consuming to code. Do the benefits of coding the score outweigh the time spent in coding it?

Comments

  • Absolutely.  Individual COMA  scores affect SOI/ROM, and can affect reimbursement.  If coded with a PDX of CVA the separate coma scales become an  MCC. The total GCS when coded does have an impact on SOI/ROM, but is not an MCC.  
    The coma is  often present on admission, patient's are very sick, and  they have a greater likelihood of dying.  Coma scales should always be coded as they affect quality outcomes and assist in accurately reflecting just how sick the patient really is.  
  • I would point out that both coding clinic and coding guidelines encourage and require the reporting of Glasgow scores.  It is right in the official coding guidelines from the cooperating parties.

    Does more really need to be said that that?? (To the coders)
  • Thanks for your input Allen. Would you be able to site the coding guidelines that require the reporting of the GCS score so I may take this back to our Coders.
  • We finally have convinced our Coder's the importance of coding the GCS score! I'm in the process of creating a GCS score query and was wondering if anyone had a query they could share.
  • One can code the GCS from notes by the RN, MD, or PA.  “Most often’, I pick them up by reviewing the flow sheet the RNs used to record Neurological Status.  Recording of GCS is very much a current process - as such, I don’t think this is an issue that lends itself to any type of query.  Rather, I’d remind the CDI and Coding Team of the importance of coding these scores...it is also helpful to know that we can code the GCS scores from the EMT run sheet, too.   Personally, I am a bit ‘amazed’ that we are allowed to code GCS scores w/o MD verification given the impact they can have on DRG assignment.

    Paul Evans, RHIA, CCDS
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