AHA Coding Clinic® for ICD-9 - 2004 Issue 2; Ask the Editor

Facility-Specific Coding Guidelines

Can you clarify the acceptable parameters of facility-specific coding guidelines? We are confused because Coding Clinic for ICD-9-CM, First Quarter 2000, page 24, seems to preclude facilities from developing internal guidelines that interpret abnormal findings without querying physicians for their clinical significance. We have seen a coding textbook that seems to contradict this interpretation. The book states “if the endocrinology department’s care plan defines ‘two sequential blood sugars over 600 mg/dl,” as uncontrolled, then the coder may assign the code. This is a fairly common facility guideline. Other common facility guidelines address postoperative blood loss anemia and hypokalemia.” ...

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