Perform a face validity review of the six (6) discharges shown in the table below to ensure compliance to official coding guidelines, which can be found in your codebook or online. Report any coding quality issues you identify from your review. Explain why, and reference the specific coding guidelines that support your explanation of the quality issues you have identified.

For this assignment, you will need to review each code in the table below for notes and you will need to review the coding guidelines for the specific code.

Step 1 - Review each code for notes: In the example below, an Excludes1 note means that the two codes are mutually exclusive; you cannot have both codes together.

Implication: This means that you cannot code D50.0 along with D62 or P61.3. You can only have one of those codes assigned. So, if you see the Principal Diagnosis is D50.0 with a secondary code of P61.3, that is an error.

Step 2 - Review the coding guidelines: You also need to review the coding guidelines Section I A and B (all) and then C for the specific code. For example, if you have a C90 code, you need to look at coding guidelines for Section I.C.2. Look for any notes about how to sequence the diagnoses and more. Examples to watch for: errors such as coding a symptom when a definitive diagnosis is given or newborn codes added to the maternal encounter. Also, review Sections II and III.

The first case in this assignment has been completed for you as an example.

TABLE: Worksheet for Identifying Coding Quality Problems

Worksheet for Identifying Coding Quality Problems
Case 1	Principal Diagnosis: B96.20 Unspecified Escherichia coli as the cause of diseases classified elsewhere Secondary Diagnosis: N39.0 Urinary tract infection, site not specified
Problem(s) Identified: Sequencing—incorrect sequencing of codes Coding Rule Violated: See Section 1.B. and #7 of the coding guidelines. The infection should be listed first followed by the organism causing the infection.
Case 2	Principal Diagnosis: A41.02 Methicillin resistant Staphylococcus aureus sepsis Secondary Diagnosis: B95.62 Methicillin-resistant Staphylococcus aureus infection as cause of diseases classified elsewhere
Problem(s) Identified: Coding Rule Violated:
Case 3	Principal Diagnosis: E10.1 Type 1 diabetes mellitus without complications Secondary Diagnosis: E11.29 Type 2 diabetes mellitus with other diabetic kidney complication
Problem(s) Identified: Coding Rule Violated:
Case 4	Principal Diagnosis: I11.0 Hypertensive heart failure Secondary Diagnosis: I10 Hypertension Secondary Diagnosis: I50.9 Heart failure, unspecified
Problem(s) Identified: Coding Rule Violated:
Case 5	Principal Diagnosis: R10.9 Unspecified abdominal pain Secondary Diagnosis: K52.9 Noninfective gastroenteritis and colitis, unspecified
Problem(s) Identified: Coding Rule Violated:
Case 6	Principal Diagnosis: O80 Encounter for full-term uncomplicated delivery Secondary Diagnosis: Z38.0 Single liveborn infant, delivered vaginally
Problem(s) Identified: Coding Rule Violated:

 

Answer rating: 100% (QA)

Case 1 Problems Identified Incorrect sequencing of codes Coding Rule Violated See Section IB and 7 o... View the full answer