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Q&A Multiple DX's in 1 category

Linda Charlwood

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Hi

If a chart has documented that the PT has substernal chest pain radiating to LT shoulder. And when pain is at it's worst feels pressure.

Should we code only 786.51 or 786.51 AND 786.59?? Can we code 2 in the same category?

Thanks for any input!

Linda
 

Lori Woods

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You can code more than once from the same category such as this example category 246 other disorders of the thyroid you could for example have 246.2 cyst of thyroid & 246.3 hemorrhage & infarction of thyroid occurring at the same time so my guess would be you could assign both the pain & the pressure. I understand why you could be confused though because now I am thinking but what if the pressure is causing the pain or vice versa would you still assign both? So good question for the CCO crew Linda.
 

Ruth Sheets

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This question was covered in the July 2013 Q&A Webinar. Yes, you can code two in the same category if you have documentation for both. You can see the video recording and read the complete transcript by joining the CCO Club.
 
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