Wiki coding pneumonia

samyjm13

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provider dx pneumonia, no labs, no xrays, can pneumonia be coded or just signs/symptoms. Pt has cough, fever, chills, sob especially when coughing.

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provider dx pneumonia, no labs, no xrays, can pneumonia be coded or just signs/symptoms. Pt has cough, fever, chills, sob especially when coughing.

???????

A physician is allowed to diagnose infective conditions based on the clinical presentation of the patient with no confirming studies being performed. So if he states pneumonia then it is, same with UTI, Otitis media, Sepsis, Strep.
 
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