Precipitous Drop in Hemoglobin
Does your facility have any guidance around the support for the diagnosis of precipitous drop in Hemoglobin?
For example, if there is a drop in Hgb post operatively but, not a significant EBL would you query for precipitous drop in Hgb? Do you include this as an option on your any of your anemia queries?
Appreciate any insight into this topic!
Comments
Hello avahey,
In general, if there is a postoperative drop in hemoglobin but the estimated blood loss is minimal and there are no other clinical indicators of bleeding, it would not typically prompt a query simply to identify a precipitous drop in hemoglobin. Although a precipitous drop in hemoglobin or hematocrit can be coded when the provider specifically documents it, using R71.0 represents an abnormal laboratory finding rather than a disease process. For that reason, most CDI programs do not always include “precipitous drop in hemoglobin” as a routine option on anemia queries. The abnormal finding must still be supported with relevant clinical indicators and the "MEAT" is often what is lacking outside of one lab value finding. Can you identify why it dropped? Hemodilution? Is it being serial monitored? Treated? Continual evaluation and follow-up documentation? If the provider independently documents a precipitous drop without identifying a specific cause, the abnormal finding may then be captured with R71.0 but again, may not be well supported from a validation standpoint. I will also send some educational slides we utilize on this if helpful.
Hope that helps.
Deanne Wilk