# Consistent with ?



## Justarose (Jul 18, 2011)

Is there a new rule or something ....ever a time when in an ASC you CAN use "consistent with" 

Please help - I have come from DoD out patient - it has really messed up my thinking 

but there are things that I just don't think change 

I am being told it is okay to use consistent with ...is it ? Where does it say it is ?

Thanks


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## mitchellde (Jul 18, 2011)

As far as I have been informed, consistent with is still considered an uncertain dx so there for cannot be coded unless you are inpatient facility coding.


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## Justarose (Jul 18, 2011)

mitchellde said:


> As far as I have been informed, consistent with is still considered an uncertain dx so there for cannot be coded unless you are inpatient facility coding.



tHANKS Debra - I didn't think it would have changed - what do you do when your QA person is telling you to do this ??


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## mitchellde (Jul 18, 2011)

point out in the guidelines where it states uncertain diagnosis cannot be coded in the outpatient setting.  To say something is consistent with still says it might yet be something different.


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## MMAYCOCK (Jul 19, 2011)

*consistent with*



Justarose said:


> Is there a new rule or something ....ever a time when in an ASC you CAN use "consistent with"
> 
> Please help - I have come from DoD out patient - it has really messed up my thinking
> 
> ...


It might be helpful to have your source documents handy. Here is an excerpt from an excellent article with references and another link to the guidelines themselves. 

*Correct reporting of an uncertain diagnosis is very different for inpatient and outpatient coding, McCall says. The ICD-9-CM guidelines in section II, Selection of Principal Diagnosis, state:

If the diagnosis documented at the time of discharge is qualified as “probable”, “suspected”, “likely”, “questionable”, “possible”, or “still to be ruled out”, or other similar terms indicating uncertainty, code the condition as if it existed or was established. The bases for these guidelines are the diagnostic workup, arrangements for further workup or observation, and initial therapeutic approach that correspond most closely with the established diagnosis.

Note: This guideline is applicable only to inpatient admissions to short-term, acute, long-term care and psychiatric hospitals.

In the outpatient setting, coders cannot code anything that isn't a confirmed diagnosis, McCall says. In section IV, Diagnostic Coding and Reporting Guidelines for Outpatient Services, the ICD-9-CM guidelines state:

Do not code diagnoses documented as “probable”, “suspected,” “questionable,” “rule out,” or “working diagnosis” or other similar terms indicating uncertainty. Rather, code the condition(s) to the highest degree of certainty for that encounter/visit, such as symptoms, signs, abnormal test results, or other reason for the visit.

Please note: This differs from the coding practices used by short-term, acute care, long-term care, and psychiatric hospitals.*

http://www.justcoding.com/267346/let-icd9cm-guidelines-lead-you-to-the-correct-diagnosis-code

Melanie


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## Justarose (Jul 19, 2011)

Melanie and Debra ; 

Thank you so much ! 

You have no idea how much your input is appreciated ...I was so beginning to doubt myself


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