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ICD-9 Respiratory
From coding guidelines Section I.8
| Question | Answer |
|---|---|
| What are the conditions that compise COPD | Obstructive chronic bronchitis and emphysema |
| T/F Code 496, Chronic airway obstruction, not elsewhere classified, is a nonspecific code that should only be sed when the documentation in a medical record does not specify the type of COPD being treated | True - if they list COPD in parts of the record and emphysema in other parts then you only code the emphysema as it is a type of COPD |
| What is an acute exacerbation of a condition? | It is a worsening ora decompensation of a chronic condition. It is NOT equivelant to an infection superimposed on a chronic condition, though an exacerbation may be triggered by an infection. |
| T/F - an acute exacerbation is the same thing as status asthmaticus | False - an acute exacerbation is an increased severity of the asthma symptoms, like wheezing and sob, while status asthmaticus refers to a patient's failure to respond to therapy administered during an asthma episode and is a life threatening complication |
| T/F If status asthmaticus is documented by the provider with any type of COPD or with acute bronchitis, the status asthmaticus should be sequenced first | True - it supercedes any type of COPD including that with acute exacerbation or acute bronchitis. |
| T/F - if a patient is documented as having an acute exacerbation of asthma and status asthmaticus, you would assign an asthma code with 5th digit 2 (with acute exacerbation) together with an asthma code with 5th digit 1, with status asthmaticus. | False - only the 5th digit 1 should be assigned. |
| T/F - when acute bronchitis is documented with COPD, you need a code for both | False - you assign the combination code 491.22, Obstructive chronic bronchitis with acute bronchitis, only - this covers all conditions. |
| T/F - If a patient has acute bronchitis and COPD exacerbation, assign a code only for the COPD exacerbation as that superseeds acute bronchitis | False - the acute bronchitis included in code 491.22 superceeds the acute exacrbation. If the pt has COPD exacerbation without acute bronchitis then use code 491.21 |
| T/F - Code 518.81, Acute respiratory faiure should be assigned as the pdx if it is the condition established, after study, to be chiefly responsible for having occasioned admission to the hosiptal | True - with the exception of specific rules governing obstetrics, poisoning, HIV, and newborns |
| T/F - Respiratory failure may be listed as a secondary diagnosis if it occurs after admission, or if it is present on admission, but does not meet the definition of principal diagnosis | True |
| T/F - When a patient is admitted with respiratory failure and another acute condition (like MI, or CVA or pneumonia, the pdx will not always be the same - it will depend on the circumstances of admission | True - Respiratory failure use to have other rules as to how it was listed as pdx, but the rules now state to follow the PDX definition - focus on this! |
Created by:
tccchar
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