Need guidance:
Example 1
Primary Admitting Diagnosis = F31.2 (Bipolar disorder, current episode, manic severe with psychotic features)
Primary Discharge Diagnosis = F31.73 (Bipolar disorder, in partial remission, most recent episode manic)
Example 2
Primary Admitting Diagnosis = F33.1 (Major depressive disorder, recurrent, moderate)
Primary Discharge Diagnosis = F33.42 (Major depressive disorder, recurrent, in full remission)
Example 3
Primary Admitting Diagnosis = F10.220 (Alcohol dependence with intoxication, uncomplicated)
Primary Discharge Diagnosis = F10.21 (Alcohol dependence, in remission)
In the above examples, the physician is trying to show (through a diagnosis) that the patient has improved during their hospitalization. The physician also narrates in the Course Summary section of the Discharge Summary the patient's improvement.
My questions:
1. In any of the examples above, what is the true primary/principle/first-listed diagnosis? In the examples, the admitting diagnosis shows the true state of the patient when they arrived/reason why they needed psychiatric hospitalization with the discharge diagnosis showing how the patient presents on the day of discharge.
2. In the above examples, if the true primary/principle/first-list diagnosis is the Primary Discharge Diagnosis, it shows the patient at a "manageable" level so how does that affect the reimbursement side? Is reimbursement lower with this diagnosis?
Any guidance would be greatly appreciated. Thanks!
Example 1
Primary Admitting Diagnosis = F31.2 (Bipolar disorder, current episode, manic severe with psychotic features)
Primary Discharge Diagnosis = F31.73 (Bipolar disorder, in partial remission, most recent episode manic)
Example 2
Primary Admitting Diagnosis = F33.1 (Major depressive disorder, recurrent, moderate)
Primary Discharge Diagnosis = F33.42 (Major depressive disorder, recurrent, in full remission)
Example 3
Primary Admitting Diagnosis = F10.220 (Alcohol dependence with intoxication, uncomplicated)
Primary Discharge Diagnosis = F10.21 (Alcohol dependence, in remission)
In the above examples, the physician is trying to show (through a diagnosis) that the patient has improved during their hospitalization. The physician also narrates in the Course Summary section of the Discharge Summary the patient's improvement.
My questions:
1. In any of the examples above, what is the true primary/principle/first-listed diagnosis? In the examples, the admitting diagnosis shows the true state of the patient when they arrived/reason why they needed psychiatric hospitalization with the discharge diagnosis showing how the patient presents on the day of discharge.
2. In the above examples, if the true primary/principle/first-list diagnosis is the Primary Discharge Diagnosis, it shows the patient at a "manageable" level so how does that affect the reimbursement side? Is reimbursement lower with this diagnosis?
Any guidance would be greatly appreciated. Thanks!