Effective Coding Under MS-DRGs - American Health Information ...

Effective Coding Under MS-DRGs
Notes/Comments/Questions
Classification of Pressure Ulcers
Smith, D. M. Ann Intern Med 1995;123:433-438
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Deleted CC
COPD – Asthma – Hypoxemia
• Most common CC under CMS
• While Coding Clinic allows COPD (not a CC) to be coded without overt
interventions, exacerbations (a CC) require interventions.
• Options
• 518.83 – Chronic respiratory failure for patients on Home Oxygen –
chronic elevation of pCO 2
• 428.20 – Chronic systolic right heart failure from chronic pulmonary
hypertension – edema, jugular venous distension, RVH on ECG
• Exacerbations -a sustained worsening of the patient’s condition, from the
stable state and beyond normal day-to-day variations, that is acute in
onset and necessitates a change in regular medication in a patient with
underlying COPD.
• Mild - Patient has an increased need for medication, which he/she can manage
in own normal environment
• Moderate - Patient has an increased need for medication and feels the need to
seek additional medical assistance
• Severe - Patient/caregiver recognizes obvious and/or rapid deterioration in
condition, requiring hospitalization
• “Status Asthmaticus” – Asthma exacerbation that does not respond to
standard treatments of bronchodilators and steroids
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AHIMA 2008 Audio Seminar Series 15
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