AHA Coding Clinic® for ICD-9 - 1988 Third Quarter

Q & A

In the review of medical records for diagnostic coding accuracy, pneumonias with unspecified bacteria are automatically assigned to code 486, Pneumonia of unspecified organism, even though the physician has attested to a diagnosis of gram-negative pneumonia or probable gram-negative pneumonia when (a) the culture and smear reveal several organisms, none of which can be identified as the causative agent, or (b) either the sputum was not obtainable or sputum reveals no growth or normal flora. In what instance would it be appropriate for the physician to use the diagnosis of gram-negative pneumonia, 482.8, Pneumonia due to other specified bacteria, in the absence of confirmatory cultures? ...

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