tci ED Coding & Reimbursement Alert - 2000 Issue 6

Reader Question: Sepsis vs. Symptoms

Question: When coding to rule out sepsis on a pediatric emergency room (ER) visit, can we code sepsis, or can we code only the symptoms?Marisha BartonSalt Lake City, UtahAnswer: Rule out diagnoses cannot be coded using any ICD-9 codes. If, in the physicians mind, the patient does have sepsis (038.9), even if it is disproved after admission, then code sepsis. If the physician cannot make that determination, then code the symptoms and comorbidities. Do not code rule out. If physicians persist in listing this type of diagnosis, an educational session needs to be held with them to...

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