PDX Advice
I have a patient that was admitted prior to surgery due to the fact that she is on coumadin for hx of antiphospholipid antibody with hypercoaguable state with chronic pe, but since she cannot take Lovenox due to her CKD Stage 4. She is admitted for heparinization prior to surgery for herniorrhaphy this admission. Would the PDx be the hernia or the hypercoaguable state?
I am thinking the hypercoaguable state since she may not have been admitted to inpatient for hernia repair.
Thanks for any help.
Betty
I am thinking the hypercoaguable state since she may not have been admitted to inpatient for hernia repair.
Thanks for any help.
Betty
Comments
Hi Betty,
there are a couple of old coding clinics about this for CCQ32002. I have included one but there is also one for a colonoscopy in the same issue.
A patient is admitted with severe dental caries and periodontal disease. She has been on Coumadin in the past for clotting of her dialysis access. This had to be stopped prior to her dental procedure and she needed to be switched to IV Heparin. The documentation states that the patient was admitted for anticoagulant adjustment prior to her surgery. In addition, the history of present illness specifies, "the primary reason for admission is not for her teeth extraction but because she has had chronic clotting problems of her vascular access for dialysis. Every time her Coumadin is stopped, the patient's access clots." It appears that the dental extraction would have been carried out as an outpatient if the patient had not had clotting problems. What should be the principal diagnosis in this case, the dental condition or V58.61 or V07.8?
Betty