Wiki ICD-9 Coding the kitchen sink

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ashack63

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I would appreciate anyone's help out there that can point me to reference material that states that only applicable Dx should be used on the claim.

Ex. Patient comes in for abscess axilla. I & D performed

Documentation reveals Fam Hx Diabetes, Fam Hx Cardiac Conditions, HTN, Smoker, Hx Asthma, Hx MI, Hx stroke, Hx Arthritis

It was always my understanding that concurrent conditions should be coded only if they have bearing on the encounter. This is not for E&M LOS


I would code 682.3, 401.9, 305.1
All the other history codes would not have any bearing on an abscess treatment

I believe this is called laundry list or kitchen sink coding if all these conditions were listed on the claim.

Can anyone provide where I can get refernce material to this?
 
Did you ever

receive an answer or come to a solution on this? I have been dealing with the same thing since we adopted EHR. The physician lists multiple codes if she's refilling meds, yet does not mention in the documentation anything that supports her MDM for refilling, just that they were filled. I can't get her to stop attaching 15 codes. Would love some documentation to back me up!
 
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Hi, the only thing I know of that's in the book is this:

Per ICD-9 office coding guidelines: “do not code diagnoses documented as ‘probable’, ‘suspected’, ‘questionable’, ‘rule out’, or ‘working diagnosis’, or other similar terms indicating uncertainty.”

Other than that, not sure where it's documented about what's appropriate to report, etc. Hope I helped a little? :)
 
In the ICD Guidelines, Section IV. K

Code all documented conditions that coexist at the time of the encounter/visit, and affect patient care treatment or management.

The Coding Clinic, 3Q, pages 13-14 instructs hospital coders to always code the chronic conditions. HOWEVER, they are clear that this advice is for hospital coders and that the guidelines for outpatient services is to code all conditions that affect patient care or management and "Conversely, conditions that do not require or affect patient care, treatment, or management are not reported."
 
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