heartyoga
Guru
The cardiologist consult as ff:
Chief Complaint: Elevated troponin consistent with Non ST elevation myocardial infarction, afib w RVR, tachycardia bradycardia, acute CHF.
Assessment:
1. NSTEMI, acute but type 2 due to demand ischemia from tachycardia
This throws our coder off bec all she sees is type 2 = I21.A1.
I was explaining that the medical records is saying clearly it is NSTEMI. Maybe there are several types of NSTEMI medically that is not in the code book. Waiting to query the physician.
She also mentioned that the doctor has to go back and change/add addendum to the tachycardia as paroxysmal tachycardia to be able to code it I47.0-I47.9 if it is I21.A1.
She said the insurance would be looking at it and we would be "in trouble". Patient is traditional Medicare and we would "harm the patient" if she didn't code it correctly and if the coder of PCP sees type 2 she would code it as I21.A1 and our codes would be flagged by the insurance. Sigh...
All I know is the physician is doing his best to provide medical care to the patient, conveying his inputs based on his medical knowledge and experience to do what's best for the patient. I don't think he should be constrained in his documentation based on what is or what is not in the code book.
Inputs and suggestions are appreciated.
Thanks !
Chief Complaint: Elevated troponin consistent with Non ST elevation myocardial infarction, afib w RVR, tachycardia bradycardia, acute CHF.
Assessment:
1. NSTEMI, acute but type 2 due to demand ischemia from tachycardia
This throws our coder off bec all she sees is type 2 = I21.A1.
I was explaining that the medical records is saying clearly it is NSTEMI. Maybe there are several types of NSTEMI medically that is not in the code book. Waiting to query the physician.
She also mentioned that the doctor has to go back and change/add addendum to the tachycardia as paroxysmal tachycardia to be able to code it I47.0-I47.9 if it is I21.A1.
She said the insurance would be looking at it and we would be "in trouble". Patient is traditional Medicare and we would "harm the patient" if she didn't code it correctly and if the coder of PCP sees type 2 she would code it as I21.A1 and our codes would be flagged by the insurance. Sigh...
All I know is the physician is doing his best to provide medical care to the patient, conveying his inputs based on his medical knowledge and experience to do what's best for the patient. I don't think he should be constrained in his documentation based on what is or what is not in the code book.
Inputs and suggestions are appreciated.
Thanks !