ED Coding and Reimbursement Alert
Check Chart for Combo Code
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? 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).
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ED Coding and Reimbursement Alert
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