heartyoga
Guru
Echo performed in office
Indications: Hypertensive heart diseases without heart failure, aortic insufficiency, mitral insufficiency, heart murmur
Measurements...
2-D Echo...
Color and Spectral Findings...
Conclusions:
1. Mild concentric LVH with LVEF of 60-65%
2. Mild left atrial enlargement
3. Diastolic dysfunction, grade 1
4. Mild aortic, mitral, tricuspid, and pulmonic insufficiency.
5.Technically difficult study, unable to calculate pulmonary pressure due to poor Doppler signal across tricuspid valve.
Coder A : coded it as I11.9, I34.0, I35.1, I51.89 (diastolic dysfunction)
This claim was rejected by UHC due to Smart Edit with the ff notations: "Per ICD 10-CM Excludes 1 note guidelines, diagnosis codes I51.89 with I11.9 identify two conditions that cannot be reported together except when the two conditions are unrelated."
My question is
-if we are supposed to be coding from the results, wouldn't coding the aortic, mitral, tricuspid, pulmonic insufficiency good enough?
-Is there a need to pull the hypertensive heart disease from the indications?
-is there reference where i can find the edits where codes shouldn't be together?
Is it bec I51.89 ill defined heart disease that once we have I11.9 which is in the I-series then the edits are reading it as we have a more specific dx so I51.89 shouldn't be there?
We code I34.0, I35.1, I36.1 routinely with diastolic dysfunction I51.89? Is there a more specific code for diastolic dysfunction in an echo interpretation context?
Thanks!
Indications: Hypertensive heart diseases without heart failure, aortic insufficiency, mitral insufficiency, heart murmur
Measurements...
2-D Echo...
Color and Spectral Findings...
Conclusions:
1. Mild concentric LVH with LVEF of 60-65%
2. Mild left atrial enlargement
3. Diastolic dysfunction, grade 1
4. Mild aortic, mitral, tricuspid, and pulmonic insufficiency.
5.Technically difficult study, unable to calculate pulmonary pressure due to poor Doppler signal across tricuspid valve.
Coder A : coded it as I11.9, I34.0, I35.1, I51.89 (diastolic dysfunction)
This claim was rejected by UHC due to Smart Edit with the ff notations: "Per ICD 10-CM Excludes 1 note guidelines, diagnosis codes I51.89 with I11.9 identify two conditions that cannot be reported together except when the two conditions are unrelated."
My question is
-if we are supposed to be coding from the results, wouldn't coding the aortic, mitral, tricuspid, pulmonic insufficiency good enough?
-Is there a need to pull the hypertensive heart disease from the indications?
-is there reference where i can find the edits where codes shouldn't be together?
Is it bec I51.89 ill defined heart disease that once we have I11.9 which is in the I-series then the edits are reading it as we have a more specific dx so I51.89 shouldn't be there?
We code I34.0, I35.1, I36.1 routinely with diastolic dysfunction I51.89? Is there a more specific code for diastolic dysfunction in an echo interpretation context?
Thanks!