kkabramson
New
A patient was admitted to the hospital for urinary retention, likely secondary to opiates though possibly anticholinergics (according to physician documentation). The hospital billed R33.0- drug-induced urinary retention as the Primary diagnosis (PDX). Another reviewer suggested the PDX should be changed to T40.605A- Adverse effect of unspecified narcotic, initial encounter and R33.0 should be moved to a secondary dx.
I’m confused by the “code first” and “code additional”. The instructions say to code first for adverse effects, the nature of the adverse effect, which in this case would be urinary retention. But the “code first” definition says the etiology should be coded before the manifestation, so that makes me think the etiology would be “adverse effect of narcotic” and the manifestation is the urinary retention.
Also, would the coding be different if the patient took the medications as prescribed, vs if they accidentally took more than prescribed?
I’m confused by the “code first” and “code additional”. The instructions say to code first for adverse effects, the nature of the adverse effect, which in this case would be urinary retention. But the “code first” definition says the etiology should be coded before the manifestation, so that makes me think the etiology would be “adverse effect of narcotic” and the manifestation is the urinary retention.
Also, would the coding be different if the patient took the medications as prescribed, vs if they accidentally took more than prescribed?