Wiki Diagnosis Vs. Another Diagnosis

[medcode12]

How do you code one diagnosis versus another? Am I supposed to just code both?

 

[dmaec]

in an outpatient physician setting - you can't code vrs - you'd code the signs/symptoms if you don't have a definitive dx - (this is for outpatient coding).
I don't do inpatient coding, yet.. but I hear we can code it as though it does exist, as though they have it...

anybody else? ......

 

[medcode12]

it's an outpatient physician setting. The doctor wrote only URI vs. Pneumonia with no symptoms. I guess I should ask her to document more stating the signs and symptoms.

 

[dmaec]

so, nothing in the documentation such as cough, difficulty breathing, congestion?...
yup, you'll need clarification on it if nothing else is provided.
outpatient setting, can't code "vrs"

 

[medcode12]

Thanks for your help! I was never completely sure of what to code when 'vrs' was in the diagnosis.