Principal diagnosis - ICD-10-CM guidelines for inpatient coding
Вставка
- Опубліковано 14 лип 2024
- Today we have a look at the selection of principal diagnosis. Why it is so important to inpatient coding, how it affects MS-DRG assignment and what the ICD-10-CM guidelines are. With examples to every guideline and visual demonstration of concepts, where applicable.
Topics addressed:
00:00 Principal diagnosis - why does it matter?
01:37 Admitting vs. Pdx
03:23 Principal diagnosis general guideline
05:47 Guideline A
06:10 Guideline B
09:19 Guideline C
11:15 Guideline D
13:35 Guidelines E & F
14:34 Guideline G
16:19 Guideline H
18:28 Guideline I
20:30 Guideline J
22:23 Guideline K
Free quizzes and more coding help:
www.thecodingguild.com
Video on MS-DRG assignment step-by-step:
• MS-DRG assignment for ...
#ccsexamprep #inpatientcoding #icd10cm
© 2021 The Coding Guild Ltd. Co. All rights reserved.
**** DISCLAIMER ****
AMA disclaimer
CPT® copyright 2021 American Medical Association. All rights reserved.
CPT® is a registered trademark of the American Medical Association.
All CPT® codes presented in the test are used under the Fair Use provision of copyright law, for educational purposes.
Legal disclaimer
Names, places, dates of birth and other personally identifiable information used in the video are entirely fictitious. No identification with actual persons (living or deceased), places, buildings, and products is intended or should be inferred. Any resemblance to actual persons living or dead, businesses, events, or locales is purely coincidental.
The author doesn't accept responsibility or liability for any adverse outcome originating from using the contents of this video. While due effort was taken, inaccuracies and errors might occur and be present. The content is provided ‘as-is’, without warranty. The author does not assume and hereby disclaim any liability to any party for any loss, damage, or disruption caused by errors or omissions, whether such errors or omissions result from negligence, accident, or any other cause.
All revenue cycle related decisions must be based on individual payer policies and financial and / or legal counsel, as necessary. Following advice in this video does not guarantee payment of services, avoidance of audits, passing grades on board or other exams or passing pre-employment tests.
The aim of this test video is to educate HIM professionals on the application of medical coding and billing rules and guidelines. The described scenarios are fictional, so are all 'treatments' outlined in the examples. The creator of this video is not licensed to practice medicine in any capacity and thus does not advise, endorse or otherwise recommend any treatment modality, drug or dosage for any disease or conditions mentioned in the content. The example scenarios are not intended to be interpreted as, or substitute medical advice or medical education. Seek medical counsel from a legally authorized healthcare practitioner for any and all questions regarding your, or others' medical care or medical training.
The perfect resource for medical coding auditing students and any practicing coding auditor!
Medical coding certifications affected: this topic is to be expected on the:
CIC exam
CCS exam
CDEI exam
A year paid course and not a single instructor ever explained sequencing like this, we were just expected to get it. Thank you!
Hi Jessa! We all teach and learn different. :) I am happy if the video helped! Best of luck on your exam or in your school work!!
Probably the best video I watched explaining principal diagnosis so much. I comprehended almost everything.
Hi Alanis! I am always happy to hear when one of my videos help people. :) Let me know if oyu have questions!
Just found your page and this was the BEST explanation of principal diagnosis I have heard. Thank you so much!
Hi Miablackwell1155! Thank you for the kind feedback! :) You are very welcome! Please let me know if you have further questions! Are you getting ready for an exam or did you watch the video for real life coding?
I am studying for the CCS. I currently have my CPC and COC. I'm hoping to nail down inpatient. Your videos are so helpful!
@@miablackwell1155 Awesome! The CCS will definitely open more doors for you, especially for facility coding (both OP and IP). Inpatient coding is scarier looking than it actually is. :) Just make sure you read the notes VERY CLOSELY and apply critical thinking while coding. 'Is this dx serious enough for admission? Did this happen during hospitalization? Did the surgeon really do a replacement or are they just using the 'wrong' word for a transfer?' etc. You got this!!
@@TheMedicalCodingGuild Thank you!!!
I really appreciate your insight - excellent presentation!!
Hi Julian! Thank you very much! Trying to give back to the community. Are you getting ready for an exam or just brushing up on rules for a new role? ;)
I have to say, that's the most useful principal diagnosis choosing video out there, keep up the good work
Thank you for reminding me of two or more comparative or contrasting conditions guidelines
Hi Shrek! Thank you very much for your kind words!! Best of luck on your exam! :)
Thank you very much!
You are very welcome! Thank you for checking out my video! Which credential are you getting ready for? CCS, CIC, CDEI, other? :)
The examples made all the difference. Thanks!
Hi Dg7438! Happy to hear they helped! Best of luck on your exam!!
@@TheMedicalCodingGuildThanks! I'm already a certified coder, but just freshening up my skills for an upcoming position. It's been a while
@@dg7438 Oh I am sorry. I hope the new position will work out!! First IP coding role? :)
@@TheMedicalCodingGuild Thank you. I did in the past but quit, took long break (decade), and now returning :) Risk Adjustment, but I'm studying for my CCS right now. I'm CPC-A atm.
@@dg7438 Got it! Have you had a look at the CRC for Risk Adjustment?
Thank you!
I am happy if it helped! Have a nice weekend!
Fabulous! Thank you so much.
Hi Bunnytalk! (Is that a bunny? Sorry, I can't see it well). Thank you for watching and for the nice comment! Best of luck on your exam!!
@@TheMedicalCodingGuild It’s the peace sign. But, bunny works too. 👍
@@talk3194 Oh yes, now that you mention, I can see it. Whoops. :D
Amazing
Thank you Chris! It is very kind of you!
Brilliant way to look at two potential PDXs @ 10:08 , by asking the question, "Would each of these Dx's separately warrant an admission?"
IP coding is hard because so much will depend on the documentation. You just have to use good judgement in deciding what is going on and why the patient is there. Try to look at it from the insurer's perspective. They love to say: I am not paying for this?! This should have / could have been OP! So yeah, try to put the patient's conditions on trial: would you REALLY need this level of care? What do you have to show for yourself? (treatment, diagnostics, nursing etc.)
Do you do any training/coaching on inpatient coding/auditing. im starting a new job can could use some help?
Hi DomLovely! Congrats on the new job!! :) Yes, I do offer coaching, please see the details here: www.thecodingguild.com/medical-coding-tutoring
section II guidelines are only used for inpatient or outpatient also ??
Hi Raju! Section II is for IP only. For OP please see Section IV
I need this ppt where I can download
Hi Thugulagam8585! The videos and presentations are copyrighted property. They cannot be downloaded or privately used without express permission from The Coding Guild. Thank you for your understanding!
Hi gd morning
Plz explain Root operations
CliniCal indications
Hi Bhargava! :) I am not sure what you mean by clinical indications, could you please elaborate? On root operations I have a short video on how to find the correct root operation in 3 simple steps, please see here: ua-cam.com/video/vmOlPuTRTeA/v-deo.html
Yes I'm a little confused on clinical indications myself.
Thanks for sharing wonderful information for selection of PDx.
If you are providing online training for IPDRG coding or related content please confirm.. I'm interested for the same.
Kamal Pal
Senior Medical Coding Analysis from India
Hi Kamal! Thank you for the positive feedback!! I am working on related training yes. Please register as a member - for free - on my website to be notified the moment they are available! Until then, I am happy to help here if you have questions and they are reasonable to answer here. Have a great day!
@ 8:58, you describe applying the guideline for choosing between HF and Myocarditis as PDX, and you say that HF is chosen because Myocarditis "was only found later as a side note" - but doesn't that meet the definition of PDX, since it was found after study? PS - you are awesome :)
Hi Andrew! The Pdx is always what necessitated the admission. Elderly patient is admitted with complicated UTI, then 2 days later myocarditis is found and treated. Pdx is the UTI because that's what they were admitted for. Now, in the video I am trying to discuss a situation where 2 conditions could both be Pdx. Depending on the situation either the CHF exacerbation or the myocarditis could be Pdx if we have reason to believe that the CHF exacerbation was caused by the myocarditis. Or if it us hard to tell what exactly the patient was admitted for. Looking back at it, my example wasn't the best. Please just remember that guideline that sometimes we can choose either or, depending on documentation and final DRG. In real life you will always choose the PDx in this situation that gives you the better DRG.