Trendale
Guest
Hello,
How do you determine when to code the rule out dx? I usually look at the medical decision making to see if any treatment for it will be done, and what they were reusted to do but if that is the only DX given, I code it. This is pertaining to inpatient consults, I know you can code rule outs for inpatient, but not outpatient. Let me give you a quick scenario:
The doctor was asked to do a consult on a patient that has SOB, wheezing, exertional dyspnea.
The DX's listed are COPD, Acute bronchitis exacerbation, SOB, Rule out pulmonary embolism or cardiac cause.
The recommendations are: Wil continue current bronchodilators, including nebulization, advair, IV corticosteroids and current antibiotics with pneumonia protocol using rocephin and zithromax. Will check D- Dimer. if this is abnormal, we will plan to proceed with lower extremity venous dopplers as well as consideration for CT angiogram of the chest to rule out occult causes for her acute exacerbation.
So, since he may plan to do Venous Dopplers and CT angiogram of the chest to rule out causes for acute exacerbation, I did not know if I should code the rule out PE dx or not. These are the codes I have to code; 493.20,491.22,786.05 and I was going to code the rule PE. Please let me know. Thanks!
How do you determine when to code the rule out dx? I usually look at the medical decision making to see if any treatment for it will be done, and what they were reusted to do but if that is the only DX given, I code it. This is pertaining to inpatient consults, I know you can code rule outs for inpatient, but not outpatient. Let me give you a quick scenario:
The doctor was asked to do a consult on a patient that has SOB, wheezing, exertional dyspnea.
The DX's listed are COPD, Acute bronchitis exacerbation, SOB, Rule out pulmonary embolism or cardiac cause.
The recommendations are: Wil continue current bronchodilators, including nebulization, advair, IV corticosteroids and current antibiotics with pneumonia protocol using rocephin and zithromax. Will check D- Dimer. if this is abnormal, we will plan to proceed with lower extremity venous dopplers as well as consideration for CT angiogram of the chest to rule out occult causes for her acute exacerbation.
So, since he may plan to do Venous Dopplers and CT angiogram of the chest to rule out causes for acute exacerbation, I did not know if I should code the rule out PE dx or not. These are the codes I have to code; 493.20,491.22,786.05 and I was going to code the rule PE. Please let me know. Thanks!
