Wiki Pulmonary Embolism I26.99

[mmelendez]

Hello Coders,
Does anyone know if pulmonary embolism specifically, I26.99, is an acute code that could NOT be reported in the outpatient setting? We have one provider who insists that it could be coded. I am looking at the coding clinic, Optum for educational material but have not found much.
Thank you in advance,
Maria

 

[baroquecoder]

Hello Coders,
Does anyone know if pulmonary embolism specifically, I26.99, is an acute code that could NOT be reported in the outpatient setting? We have one provider who insists that it could be coded. I am looking at the coding clinic, Optum for educational material but have not found much.
Thank you in advance,
Maria

It is an inpatient diagnosis, yes an acute code. At my job we can't pick up I26.99 if it has been greater than 6 months since the incident. We generally query to find out if the acute event has resolved, if it's a chronic condition or if it is historical. Your provider is wrong. You can't continually have an acute pulmonary embolism.