tci ED Coding & Reimbursement Alert - 2004 Issue 4

Don't Infect Your Claims With Sepsis Coding Errors

Diagnosis coding success eliminates mistakesIf you're mixed up about which codes to report for sepsis and SIRS, you're not alone. And if you're unfamiliar with its exact pathology, you can easily misinterpret documentation -- which doesn't help your confusion. Follow these expert hints to spot giveaway terms and symptoms. Coders often mistake a diagnosis of "sepsis" and "SIRS" (systemic inflammatory response syndrome) with infection, when the former conditions are actually responses to infection, says James Kennedy, MD, CCS, vice president of MA Health Solutions Inc. in Nashville, Tenn. A patient cannot develop sepsis without first having SIRS --...

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