Reader Question:
Check Chart for Combo Code
Published on Thu Oct 28, 2004
Question: A patient with blood in her stool and diverticulosis presented in the ED. The physician's documentation does not specifically link the two conditions, but I am wondering whether I should report 562.12 (Diverticulosis of colon with hemorrhage). Computer edits keep telling me that if the doctor doesn't say the bleeding doesn't come from the diverticulosis, I need to report the combination code. What is correct?
Montana Subscriber Answer: Your solution is correct - you should indeed code to the highest degree of specificity. Unless the physician documentation specifically states that the gastrointestinal lesion is not the cause of bleeding, you should use the "with hemorrhage" code associated with that lesion - in this case, diverticulosis with hemorrhage (562.12).
